Zuniga J R, Chen N, Phillips C L
Department of Oral and Maxillofacial Surgery, University of North Carolina at Chapel Hill, School of Dentistry 27599-7450, USA.
J Oral Maxillofac Surg. 1997 Jan;55(1):2-13; discussion 13-4. doi: 10.1016/s0278-2391(97)90434-1.
The objective of these studies was to measure the impact of Class IV and V lingual nerve injuries on taste sensitivity and taste receptor density of the anterior tongue before and after microneurosurgical repair.
Citric acid detection threshold and suprathreshold magnitude response were measured on the anterior tongue in 12 adult volunteers with unilateral lingual nerve Class IV or V injuries. The right and left sides of the anterior tongue were tested at each session to assess the effect of nerve damage before and 1, 3, 6, and 12 months after repair. Whole-mouth threshold and suprathreshold scales of citric acid taste intensity were measured. The level of sensory impairment was scaled at each test session using a clinical neurosensory test algorithm. Finally, patients completed an 11-item instrument survey that queried the patient's perceived expectations of surgery on sensory, taste, and general health before surgery and the patient's perceived outcome of surgery at each postrepair session. The patient's perceived global satisfaction of surgery was also assessed.
All 12 patients failed to detect and scale citric acid and had complete or severe sensory impairment on the injured side of the anterior tongue. One year after repair, 50% of the patients demonstrated a substantial increase in the number of fungiform papillae, pores, and ratio of pores/papilla at the same time as they demonstrated the ability to detect and scale citric acid. After repair, patients perceived the greatest improvements in the categories of eating, chewing, feeling, and taste, and the least in speech.
Lingual nerve repair may result in significant changes in somatosensory and chemosensory function and taste bud anatomy on the anterior tongue over time.
这些研究的目的是测量IV级和V级舌神经损伤对显微神经外科修复前后舌前部味觉敏感性和味觉受体密度的影响。
对12例单侧舌神经IV级或V级损伤的成年志愿者的舌前部进行柠檬酸检测阈值和阈上强度反应测量。每次检查时对舌前部的左右两侧进行测试，以评估修复前及修复后1、3、6和12个月神经损伤的影响。测量全口柠檬酸味觉强度的阈值和阈上量表。在每次测试时使用临床神经感觉测试算法对感觉障碍程度进行分级。最后，患者完成一项包含11个项目的问卷调查，询问患者术前对手术在感觉、味觉和总体健康方面的预期，以及修复后各阶段患者对手术效果的感知。还评估了患者对手术的总体满意度。
所有12例患者均无法检测和评估柠檬酸，且舌前部损伤侧存在完全或严重的感觉障碍。修复后一年，50%的患者同时表现出菌状乳头数量、小孔数量及小孔/乳头比例大幅增加，并且能够检测和评估柠檬酸。修复后，患者在进食、咀嚼、感觉和味觉方面的改善最为明显，而在言语方面的改善最少。
随着时间的推移，舌神经修复可能会导致舌前部的躯体感觉和化学感觉功能以及味蕾解剖结构发生显著变化。
