Shinozaki K, Kobayashi T, Seki N, Iwanaga J, Kusukawa J
Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan; Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Saga, Japan.
Int J Oral Maxillofac Surg. 2025 Mar;54(3):261-267. doi: 10.1016/j.ijom.2024.08.029. Epub 2024 Aug 29.
Neurosensory disturbances (NSD) are the most widely recognized complication of bilateral sagittal split ramus osteotomy (BSSRO), but predictors of NSD remain unclear. The aim of this study was to identify factors predicting NSD following BSSRO. A retrospective cohort study of 129 consecutive patients with dentofacial deformities (median age 24.0 years; 76.0% female), who underwent BSSRO (95 without genioplasty, 34 with genioplasty), was conducted. The presence of NSD was evaluated at 6 months postoperatively and was found in 97 patients (absent in 32 patients). Potential NSD-related factors investigated were age, sex, genioplasty, mandibular canal type, inferior alveolar nerve (IAN) exposure, mandibular movement, and laterality. Multivariate binary logistic regression analysis was conducted to elucidate factors predicting NSD, with calculation of odds ratios (OR) and 95% confidence intervals (CI). The dependent variable was defined as NSD after BSSRO. Independent variables were those with P < 0.100 in the univariate analysis. In the multivariate binary logistic regression analysis, NSD showed a significant association with BSSRO with genioplasty (adjusted OR 3.87, 95% CI 1.21-12.26; P = 0.022) and left IAN exposure (adjusted OR 4.69, 95% CI 1.49-14.73; P = 0.008). The study findings may lead to enhanced clinical outcomes for BSSRO.
神经感觉障碍(NSD)是双侧矢状劈开下颌支截骨术(BSSRO)最广为人知的并发症,但NSD的预测因素仍不明确。本研究的目的是确定BSSRO术后NSD的预测因素。对129例连续的牙颌面畸形患者(中位年龄24.0岁;76.0%为女性)进行了一项回顾性队列研究,这些患者接受了BSSRO(95例未行颏成形术,34例行了颏成形术)。术后6个月评估NSD的存在情况,发现97例患者存在NSD(32例患者不存在)。研究的潜在NSD相关因素包括年龄、性别、颏成形术、下颌管类型、下牙槽神经(IAN)暴露、下颌运动和左右侧别。进行多变量二元逻辑回归分析以阐明NSD的预测因素,并计算比值比(OR)和95%置信区间(CI)。因变量定义为BSSRO术后的NSD。自变量为单变量分析中P < 0.100的因素。在多变量二元逻辑回归分析中,NSD与行颏成形术的BSSRO(调整后的OR为3.87,95% CI为1.21 - 12.26;P = 0.022)和左侧IAN暴露(调整后的OR为4.69,95% CI为1.49 - 14.73;P = 0.008)显著相关。研究结果可能会改善BSSRO的临床效果。