Iwanaga Joe, Tubbs R Shane
Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA.
Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Surg Radiol Anat. 2020 Jan;42(1):49-53. doi: 10.1007/s00276-019-02345-1. Epub 2019 Sep 19.
Lingual nerve (LN) palsy is a serious complication in dentistry and repaired by direct suture or a free graft technique. To our knowledge, there has been no study using a (long) buccal nerve (BN) graft as a donor for LN repair. Therefore, we aimed to clarify the location of the BN and investigate if it is feasible to reroute the BN to the LN.
Twenty-four sides from 12 fresh-frozen Caucasian cadaveric heads were used in this study. The mean age at death was 73.9 ± 13.4 years. The LN was dissected on the floor of the oral cavity medial to the third molar tooth. Next, the mucosa with the buccinator muscle, pterygomandibular raphe, and superior pharyngeal constrictor muscle on the retromolar area was retracted anteriorly to widen the pathway of the LN. Finally, the BN was cut and transposed to the LN through this widened pathway to its feasibility.
The mean diameter of the BN and vertical distance from the horizontal part of the retromolar trigone to the BN was 1.47 ± 0.32 mm and 18.53 ± 6.21 mm, respectively. On all sides, the BN was able to be transposed to the LN without tension.
Such a technique might be used for the patients with LN injury and who have lost sensation of the tongue.
舌神经（LN）麻痹是牙科领域的一种严重并发症，可通过直接缝合或游离移植技术进行修复。据我们所知，尚无研究使用（长）颊神经（BN）移植作为LN修复的供体。因此，我们旨在明确BN的位置，并研究将BN改道至LN是否可行。
本研究使用了12个新鲜冷冻的白种人尸体头部的24侧。平均死亡年龄为73.9±13.4岁。在口腔底部第三磨牙内侧解剖LN。接下来，将磨牙后区带有颊肌、翼下颌韧带和咽上缩肌的黏膜向前牵拉，以拓宽LN的路径。最后，切断BN并通过这条拓宽的路径将其移位至LN，以评估其可行性。
BN的平均直径以及从磨牙后三角水平部分到BN的垂直距离分别为1.47±0.32毫米和18.53±6.21毫米。在所有侧别中，BN均能够无张力地移位至LN。
这种技术可能适用于LN损伤且舌部失去感觉的患者。
