Nakanishi Takashi, Yamamoto Yuta, Tanioka Kensuke, Shintani Yukari, Tojyo Itaru, Fujita Shigeyuki
1Department of Oral and Maxillofacial Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509 Japan.
2Department of Anatomy and Cell Biology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8509 Japan.
Maxillofac Plast Reconstr Surg. 2019 Dec 27;41(1):61. doi: 10.1186/s40902-019-0244-y. eCollection 2019 Dec.
The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury.
We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody.
In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases.
Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.
舌神经损伤后进行显微神经外科手术的恢复预后因个体病例而异。本研究旨在调查舌神经损伤后6个月内进行显微神经外科手术是否能提高感觉和味觉功能的恢复率。
我们回顾性评估了2004年7月至2016年12月期间在和歌山县立医科大学医院因舌神经损伤接受显微神经外科手术的70例患者。术前使用静态两点辨别试验、完整的浅表疼痛/触觉感觉试验和味觉辨别试验对舌神经的感觉和味觉功能进行评估。术后12个月和24个月再次进行评估。在用抗S-100β抗体进行免疫组织化学染色后，使用ImageJ软件分析切除的创伤性神经瘤中雪旺细胞的丰度比。
在早期病例（损伤后6个月内进行显微神经外科手术）中，显微神经外科手术后24个月时感觉和味觉功能的恢复率与晚期病例（损伤后6个月以上进行显微神经外科手术）相比无显著差异。同时，与早期病例相比，晚期病例在显微神经外科手术后12个月内味觉恢复的患者比例显著降低。晚期病例中创伤性神经瘤中雪旺细胞的丰度比也显著降低。
舌神经损伤后6个月以上进行显微神经外科手术不会导致感觉和味觉功能恢复率降低，但会导致味觉恢复时间延长。这种延迟可能与创伤性神经瘤中雪旺细胞丰度比的降低有关。
