Oyama Aoi, Nakamura Ryota, Nakakawaji Mikumo, Nishikawa Daisuke, Beppu Shintaro, Maruyama Yoko, Okumura Seiko, Hanai Nobuhiro, Takanari Keisuke
From the Department of Plastic and Reconstructive Surgery, Aichi Cancer Center, Nagoya, Japan.
Department of Head and Neck Surgery, Aichi Cancer Center, Nagoya, Japan.
Plast Reconstr Surg Glob Open. 2024 Oct 3;12(10):e6214. doi: 10.1097/GOX.0000000000006214. eCollection 2024 Oct.
Facial sensory nerves play vital roles in daily functions like self-protection, facial expressions, speaking, and eating. Severing the infraorbital nerve (ION) during partial maxillectomy via the Weber-Ferguson incision can lead to sensory disturbances. This study presents immediate ION reconstruction using artificial nerve conduits and its short-term outcomes.
This retrospective study included three patients (mean age: 67.0 years) undergoing immediate ION reconstruction after partial maxillectomy via the Weber-Ferguson incision. Sensory recovery was evaluated using the Semmes-Weinstein and two-point discrimination (2PD) tests. A reference group of five patients who underwent total maxillectomy without ION reconstruction was also assessed.
No postoperative complications were observed during the 15.3-month follow-up. Sensory recovery varied among patients, with one achieving normal perception at 24 months, another showing diminished light touch at 13 months, and the third experiencing diminished protective sensation at 7 months postoperatively. In comparison, the reference group showed lower sensory recovery. Two patients showed improvements in 2PD test results at 24 and 13 months, whereas one showed no recovery at 7 months. No patients in the reference group showed improvement.
Immediate ION reconstruction using artificial nerve conduits after partial maxillectomy appears feasible, as evidenced by acceptable sensory recovery in the short term.
面部感觉神经在自我保护、面部表情、说话和进食等日常功能中起着至关重要的作用。通过韦伯-弗格森切口进行部分上颌骨切除术中切断眶下神经（ION）可导致感觉障碍。本研究介绍了使用人工神经导管进行ION即刻重建及其短期结果。
这项回顾性研究纳入了3例（平均年龄：67.0岁）通过韦伯-弗格森切口进行部分上颌骨切除术后即刻进行ION重建的患者。使用Semmes-Weinstein和两点辨别（2PD）测试评估感觉恢复情况。还评估了一个由5例未进行ION重建的全上颌骨切除术患者组成的对照组。
在15.3个月的随访期间未观察到术后并发症。患者的感觉恢复情况各不相同，1例在术后24个月达到正常感知，另1例在术后13个月轻触觉减退，第3例在术后7个月保护性感觉减退。相比之下，对照组的感觉恢复情况较差。2例患者在术后24个月和13个月时2PD测试结果有所改善，而1例在术后7个月时未恢复。对照组中没有患者显示出改善。
部分上颌骨切除术后使用人工神经导管进行ION即刻重建似乎是可行的，短期可接受的感觉恢复证明了这一点。
