Perez Cristina, de Leeuw Reny, Escala P Francisco, Fuentealba Rodrigo, Klasser Gary D
J Am Dent Assoc. 2023 Jan;154(1):79-93. doi: 10.1016/j.adaj.2022.03.007. Epub 2022 May 26.
Numb chin syndrome (NCS) is a rare sensory neuropathy involving the mental nerve. Symptoms of NCS are often overlooked because of their apparent innocent nature; however, owing to the frequent association of NCS with malignancies, the opposite should be the rule. Oral health care professionals may be the first to encounter patients with NCS and should be aware of its clinical characteristics in an effort to decrease patient morbidity and mortality.
A search in PubMed (MEDLINE) and the Cochrane Library was performed using the terms numb chin syndrome, numb chin, mental neuropathy, mental nerve neuropathy, and malignant mental nerve neuropathy, yielding 2,374 studies. After inclusion and exclusion criteria were applied, 102 studies remained. Descriptive statistics were performed, analyzing the etiology responsible for NCS, characteristics of NCS including associated symptoms, unilateral or bilateral nature, and information on professionals visited and examinations requested to make a diagnosis.
NCS was associated with malignancy in 29% through 53% of the published cases. Twenty-eight percent of patients initially consulted an oral health care professional with the symptom of a numb chin. Patients more likely to have NCS were those from the ages of 61 through 70 years; 74% were unilateral; and the most common symptoms reported were numbness (100%), paresthesia (18%), and pain (17%). Forty-seven percent of the NCS cases were associated with a recurrent malignancy, and the most prevalent associated diagnoses were breast cancer (32%) and lymphoma and leukemia (24%).
Oral health care professionals should be aware of the characteristics of NCS as they may be the first health care providers consulted for these symptoms.
A thorough medical and dental history as well as a complete cranial nerve screening should be performed on all patients, especially those with numbness, as this may prevent misdiagnosis and allow a timely referral and a substantial improvement of treatment course and prognosis.
麻木性颏部综合征（NCS）是一种累及颏神经的罕见感觉神经病。NCS的症状因其看似无害的性质常被忽视；然而，由于NCS与恶性肿瘤频繁相关，情况恰恰相反，应予以重视。口腔保健专业人员可能是最早接触NCS患者的人，应了解其临床特征，以降低患者的发病率和死亡率。
在PubMed（MEDLINE）和Cochrane图书馆中使用术语“麻木性颏部综合征”“麻木性颏部”“颏神经病变”“颏神经神经病”和“恶性颏神经神经病”进行检索，共得到2374项研究。应用纳入和排除标准后，剩余102项研究。进行了描述性统计，分析了导致NCS的病因、NCS的特征（包括相关症状、单侧或双侧性质）以及有关就诊专业人员和为做出诊断所要求检查的信息。
在已发表的病例中，29%至53%的NCS与恶性肿瘤相关。28%的患者最初因颏部麻木症状咨询口腔保健专业人员。年龄在61至70岁的患者更易患NCS；74%为单侧；报告的最常见症状为麻木（100%）、感觉异常（18%）和疼痛（17%）。47%的NCS病例与复发性恶性肿瘤相关，最常见的相关诊断为乳腺癌（32%）以及淋巴瘤和白血病（24%）。
口腔保健专业人员应了解NCS的特征，因为他们可能是因这些症状而被咨询的首批医疗保健提供者。
应对所有患者，尤其是有麻木症状的患者进行全面的医学和牙科病史询问以及完整的颅神经筛查，因为这可能防止误诊，并允许及时转诊，从而大幅改善治疗过程和预后。
