Craniofacial Center, Seattle Children's Hospital, Divisions of Oral and Maxillofacial Surgery and Plastic and Craniofacial Surgery, Seattle, WA, USA; Department of Surgery, Division of Plastic Surgery, University of Washington School of Medicine, Seattle, WA, USA.
Craniofacial Center, Seattle Children's Hospital, Divisions of Oral and Maxillofacial Surgery and Plastic and Craniofacial Surgery, Seattle, WA, USA.
Int J Oral Maxillofac Surg. 2022 Mar;51(3):371-375. doi: 10.1016/j.ijom.2021.07.002. Epub 2021 Jul 28.
Neurosensory disturbance of the inferior alveolar nerve (IAN) is an adverse effect associated with sagittal split osteotomies (SSO). The purpose of this work was to evaluate neurosensory recovery of the IAN when SSOs were performed with piezoelectric (PZ) versus reciprocating (RP) saws. This was a prospective split-mouth study of patients undergoing bilateral SSO using a PZ saw on one side and an RP saw on the other. The primary outcome of interest was neurosensory recovery, as assessed using the functional sensory recovery (FSR) scale defined by the UK Medical Research Council. Descriptive, bivariate, and regression statistics were computed. Twenty patients (40 SSOs) with a mean age of 19.9 ± 3.2 years were included. The mean mandibular movement did not differ significantly (P = 0.50) between the PZ and RP groups. All patients achieved FSR within 1 year of surgery (range 34-249 days). The median time to FSR overall was comparable between the PZ and RP groups (94.5 days and 101.5 days, respectively; P = 0.20). However, at the time FSR was achieved, PZ SSO sites were more likely to have higher neurosensory scores when compared to RP SSO sites (hazard ratio 2.3, 95% confidence interval 1.1-4.9, P = 0.04).
下牙槽神经（IAN）感觉神经障碍是矢状劈开截骨术（SSO）的一种不良反应。本研究旨在评估使用压电（PZ）锯与往复锯（RP）进行 SSO 时 IAN 感觉神经恢复情况。这是一项前瞻性双侧 SSO 劈裂口研究，一侧使用 PZ 锯，另一侧使用 RP 锯。主要研究结果是使用英国医学研究理事会定义的功能感觉恢复（FSR）量表评估的感觉神经恢复情况。计算了描述性、双变量和回归统计数据。共纳入 20 名年龄 19.9 ± 3.2 岁的患者（40 例 SSO）。PZ 和 RP 组的下颌运动平均值无显著差异（P = 0.50）。所有患者均在术后 1 年内达到 FSR（范围 34-249 天）。PZ 和 RP 组之间总体 FSR 达到时间中位数无显著差异（分别为 94.5 天和 101.5 天；P = 0.20）。然而，在达到 FSR 时，与 RP SSO 部位相比，PZ SSO 部位的感觉神经评分更高（风险比 2.3，95%置信区间 1.1-4.9，P = 0.04）。
