Blomqvist J E, Alberius P, Isaksson S
Department of Oral and Maxillofacial Surgery, Länssjukhuset, Halmstad, Sweden.
Plast Reconstr Surg. 1998 Aug;102(2):325-33. doi: 10.1097/00006534-199808000-00005.
Bilateral sagittal split osteotomy may be associated with postoperative sensory deficiency in the area innervated by the inferior alveolar nerve. The aim of this study was to assess the neurosensory response of the inferior alveolar nerve after such surgery. Fifty consecutive patients receiving mandibular setback or advancement were investigated. Four different neurosensory tests were used: light touch, pin prick, static two-point discrimination, and vibration thresholds. These tests were performed preoperatively, 2 days, as well as 3 months and 12 months postoperatively. The methodologic error was found negligible. The pin prick and light touch tests as well as vibratory thresholds often disclosed a short period of decreased local sensibility, whereas static two-point discrimination displayed a slightly more extended postoperative sensory reduction. The patients did not experience any practical problems or essential drawbacks postoperatively. The only variable significantly associated with neurosensory disturbance was age. In conclusion, bilateral sagittal split osteotomy, when properly performed, must be considered a safe and reliable surgical technique, even from a neurosensory point of view.
双侧矢状劈开截骨术可能与下牙槽神经支配区域术后感觉缺失有关。本研究的目的是评估此类手术后下牙槽神经的神经感觉反应。对连续50例接受下颌后缩或前徙手术的患者进行了调查。使用了四种不同的神经感觉测试:轻触觉、针刺觉、静态两点辨别觉和振动阈值。这些测试在术前、术后2天、3个月和12个月进行。发现方法学误差可忽略不计。针刺觉和轻触觉测试以及振动阈值常显示局部感觉有短时间下降,而静态两点辨别觉显示术后感觉减退时间稍长。患者术后未出现任何实际问题或重大缺陷。与神经感觉障碍显著相关的唯一变量是年龄。总之,双侧矢状劈开截骨术,若操作得当,即使从神经感觉角度来看,也必须被视为一种安全可靠的手术技术。