Use of Gore-Tex tubing as a conduit for inferior alveolar and lingual nerve repair: experience with 6 cases.
OBJECTIVE
This report evaluates treatment outcomes associated with the use of Gore-Tex (GT; W.L. Gore & Associates, Flagstaff, AZ) vein graft tubing as a conduit for repair of inferior alveolar nerve (IAN) and lingual nerve (LN) continuity defects.


METHODS
Six patients (5 female and 1 male) with painful dysesthesia secondary to injuries of the IAN (n = 3) or LN (n = 3) underwent surgical exploration and resection of pathologic tissue. Reconstruction of the resultant continuity defects was performed using 3-mm diameter GT tubing sutured to the epineurium of the proximal and distal nerve trunks. Nerve reconstruction was performed an average of 20 months after injury (range, 4 to 48 months). Patients were tested before and after surgery with the following tests: subjective pain level using an analogue scale, sharp stimulus, touch, cold sensation, directional sense, and 2-point discrimination.


RESULTS
Four patients reported no change in subjective pain level, and 2 patients had minimal decrease in pain. Two patients reported some sensation to sharp stimulus, and 1 patient was hypersensitive. Three patients responded to touch, and 3 had no response. Four patients had no response to cold sensation, and 2 had a delayed response. Only 1 patient could detect brushstroke direction. Three patients had no response to 2-point discrimination, and 3 responded at greater than 20 mm.


CONCLUSIONS
Use of GT tubing in this group of patients produced poor clinical outcomes and is not recommended for nerve reconstruction of IAN and LN continuity defects.
Pitta
M C
MC
Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A & M University System, and Baylor University Medical Center, Dallas, TX, USA.
Wolford
L M
LM
Mehra
P
P
Hopkin
J
J
D000328:Adult; D001672:Biocompatible Materials; D020209:Cranial Nerve Injuries / Q000601:surgery*; D004192:Discrimination, Psychological; D005157:Facial Pain / Q000601:surgery; D005260:Female; D006801:Humans; D008036:Lingual Nerve / Q000601:surgery*; D061222:Lingual Nerve Injuries; D008297:Male; D008340:Mandibular Nerve / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation; D010147:Pain Measurement; D011138:Polytetrafluoroethylene; D015607:Stents; D017211:Treatment Failure; D061221:Trigeminal Nerve Injuries
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene