Reducing lingual nerve damage in third molar surgery: a clinical audit of 1350 cases.
Several publications reporting lingual nerve damage in the region of 11% caused the author to undertake a retrospective personal clinical audit of 100 cases which demonstrated a comparable complication rate of 10%. This audit prompted a re-evaluation of the detailed surgical anatomy, the design and manufacture of a new type of periosteal elevator and lingual nerve retractor and a modification of the surgical technique. A subsequent prospective personal clinical audit of 1001 consecutive wisdom tooth operations has resulted in a 20-fold improvement (0.5%) in the incidence of lingual nerve damage. The technique and instrumentation has been used under local anaesthesia and under general anaesthesia by surgeons of varying experience and has a group audit complication rate of only 1% in 300 consecutive cases. The value of clinical audit has become self evident.
Walters
H
H
Department of Maxillofacial Surgery, Torbay Hospital, Torquay, Devon.
D006801:Humans; D061222:Lingual Nerve Injuries; D008485:Medical Audit; D008964:Molar, Third / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods