From the Craniofacial Center, Divisions of Plastic and Craniofacial Surgery and Oral and Maxillofacial Surgery, Seattle Children's Hospital; and Department of Surgery, Division of Plastic Surgery, and Department of Oral and Maxillofacial Surgery, University of Washington.
Plast Reconstr Surg. 2023 Jul 1;152(2):167-170. doi: 10.1097/PRS.0000000000010280. Epub 2023 Jun 29.
The purpose of this study was to evaluate whether neurosensory recovery of the inferior alveolar nerve (IAN) is influenced by its location following sagittal split osteotomy (SSO) in patients undergoing large mandibular movements. This was a prospective, split-mouth study of skeletally mature patients undergoing bilateral SSO. Patients were included as study subjects if they underwent bilateral SSO for mandibular advancement greater than 10 mm and, following the splits, the IAN was freely entering the distal segment on one side and within the proximal segment on the other. Descriptive, bivariate, and Kaplan-Meier statistics were computed. The study sample included 13 subjects (eight female subjects; mean age, 18.7 ± 1.8 years) undergoing 26 SSOs. Eleven subjects underwent bimaxillary surgery; 10 had simultaneous genioplasty. The mean mandibular movement was 12.2 ± 1.4 mm and was not significantly different between sides ( P = 0.43). All subjects achieved functional sensory recovery (FSR) bilaterally within 1 year of surgery. There was no difference in the median times to FSR based on the location of the IAN (distal segment, 105 days, versus proximal segment, 126 days; P = 0.57). In SSO for mandibular advancement with movements greater than 10 mm, leaving the IAN within the proximal segment may not impact time to FSR.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
本研究旨在评估在接受大下颌运动的患者中，下颌骨矢状劈开截骨术后（SSO）神经感觉恢复是否受其位置影响。这是一项前瞻性、双侧劈裂口的病例对照研究，纳入的患者为接受双侧 SSO 以实现下颌前伸大于 10mm 的患者，且在劈开后，神经感觉恢复在一侧自由进入远段，而在另一侧则位于近段。计算了描述性、双变量和 Kaplan-Meier 统计学数据。研究样本包括 13 名患者（8 名女性；平均年龄 18.7±1.8 岁），共进行了 26 次 SSO。11 名患者接受了双颌手术；10 名患者同时进行了颏成形术。下颌运动的平均距离为 12.2±1.4mm，两侧之间无显著差异（P=0.43）。所有患者均在术后 1 年内实现双侧功能性感觉恢复（FSR）。根据 IAN 的位置，FSR 的中位时间没有差异（远段为 105 天，近段为 126 天；P=0.57）。在进行大于 10mm 的下颌前伸 SSO 时，将 IAN 保留在近段可能不会影响 FSR 的时间。
临床问题/证据水平：风险，II。
