Neurosensory recovery after ligation of the descending palatine neurovascular bundle during Le Fort I osteotomy.
OBJECTIVE
The effect of ligating the descending palatine neurovascular bundle (DPNB) on the recovery of palatal sensation has not been clearly established. The purpose of this study was to determine the effect of ligation of the DPNB on the recovery of palatal sensation after Le Fort I osteotomy.


METHODS
Using a retrospective study design in a randomized protocol, patients who had undergone Le Fort I osteotomy were assigned to either treatment group 1 (DPNB ligated) or treatment group 2 (DPNB preserved). A third group of control patients (group 3, unoperated) on whom no surgery had been performed served as a baseline for examination of normal palatal sensation. The predictor variables were ligation and preservation of the DPNB. The outcome variables were mean tactile sensation and mean nociception. Other study variables included age, sex, follow-up, surgical movements, and number of segments.


RESULTS
There were 11 patients in group 1, 7 in group 2, and 10 in group 3. For tactile sensation, the mean Von Frey hair size detected was 4.26 +/- 0.37, 4.11 +/- 0.17, and 3.68 +/- 0.24 for groups 1, 2, and 3, respectively. The difference between group 1 and group 2 was not significant (P > .05). The differences between group 1 and group 3 and between group 2 and group 3 were significant (P < .05). For nociception, the mean pressure was 51.09 +/- 21.73, 50.89 +/- 19.19, and 56.25 +/- 19.02 for groups 1, 2, and 3, respectively. The difference between the 3 groups was not significant (P = .8064).


CONCLUSIONS
The results of this study suggest that recovery of palatal sensation is not adversely affected by ligation of the DPNB.
Bouloux
G F
GF
Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Bays
R A
RA
D000328:Adult; D000704:Analysis of Variance; D001158:Arteries / Q000601:surgery; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D009416:Nerve Regeneration; D006472:Oral Hemorrhage / Q000517:prevention & control; D019340:Osteotomy, Le Fort / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010159:Palate / Q000098:blood supply* / Q000294:innervation*; D010525:Peripheral Nerves / Q000601:surgery; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology* / Q000503:physiopathology; D018709:Statistics, Nonparametric