Al-Din O F, Coghlan K M, Magennis P
Joint Department of Oral and Maxillofacial Surgery, Eastman Dental and University College Hospitals, London, UK.
Int J Oral Maxillofac Surg. 1996 Feb;25(1):13-9. doi: 10.1016/s0901-5027(96)80005-1.
This study assessed sensory nerve disturbance after Le Fort I osteotomy using the electric pulp test, pin-prick sensation, fine touch, and cold sensation. After 6 months, 78% of teeth positive preoperatively to an electric pulp tester regained sensitivity. Return of palatal sensation was affected by whether or not the greater palatine nerve (GPN) was divided during surgery. After 6 months, where the GPN was intact, all patients had fine touch sensation (88% at the preoperative level), and all had pin-prick sensation (97% at preoperative level). When the GPN was divided, all patients had fine touch sensation (13% at preoperative level), and all had pin-prick sensation (63% at preoperative level). The differences in the return to preoperative sensation were significant for fine touch (P=0.0001++) and for pin-prick (P-0.03) by chi-square analysis. Sensation returned more quickly and more completely in the two cases where the contralateral GPN was intact. In the buccal mucosa, 95% of patients regained some fine touch sensation after 6 months, but none returned to the preoperative level. Similarly, 85% regained some pin-prick sensation, but none achieved preoperative levels. Cold sensation, pin-prick sensation, and fine touch on the face returned to the preoperative level in all patients by 6 weeks postoperatively.
本研究采用牙髓电活力测试、针刺觉、轻触觉和冷觉评估了Le Fort I型截骨术后的感觉神经障碍情况。6个月后，术前牙髓电活力测试呈阳性的牙齿中，78%恢复了感觉。腭部感觉的恢复受手术中腭大神经（GPN）是否被切断的影响。6个月后，若GPN完整，所有患者均有轻触觉（为术前水平的88%），且所有患者均有针刺觉（为术前水平的97%）。当GPN被切断时，所有患者均有轻触觉（为术前水平的13%），且所有患者均有针刺觉（为术前水平的63%）。经卡方分析，轻触觉（P = 0.0001++）和针刺觉（P = 0.03）恢复至术前感觉的差异具有统计学意义。在对侧GPN完整的两例患者中，感觉恢复得更快且更完全。在颊黏膜，95%的患者在6个月后恢复了一些轻触觉，但均未恢复至术前水平。同样，85%的患者恢复了一些针刺觉，但均未达到术前水平。术后6周时，所有患者面部的冷觉、针刺觉和轻触觉均恢复至术前水平。
