Functional sensory recovery after trigeminal nerve repair.
OBJECTIVE
The aim of this study was to estimate the proportion of subjects who achieved functional sensory recovery (FSR) 1 year after inferior alveolar or lingual nerve repair and to identify risk factors associated with failure to achieve FSR.


METHODS
Using a retrospective cohort study design, we developed a sample composed of subjects who underwent lingual or inferior alveolar nerve repair. Eligible subjects had at least 1 postoperative visit. For subjects having bilateral nerve repair, 1 side was selected randomly for analysis. Predictor variables were categorized as demographic, anatomic, and operative. The outcome variable was the time to FSR, measured in days. Kaplan-Meier survival methods were used to estimate the proportion of subjects with FSR at 1 year. Uni- and multivariate Cox proportional hazard models were used to identify risk factors for the failure to reach FSR at 1 year.


RESULTS
The study sample was composed of 60 subjects with a mean age of 28.7 +/- 8.3 years; 68.3% were female. The majority (86.7%) of subjects presented with a preoperative chief complaint of altered sensation and had lingual nerve damage (93.3%) that was repaired by direct suturing (75%). The mean interval between injury and repair was 145.9 +/- 200.0 days. At 1 year postoperatively, 75% of the subjects had achieved FSR (95% confidence interval [CI]: 64% to 86%).


CONCLUSIONS
The majority of subjects undergoing trigeminal (V(3)) nerve repair achieved functional sensory recovery within 1 year of surgical repair. Patients with evidence of neuroma formation were less likely to achieve FSR at 1 year in a multivariate model.
Susarla
Srinivas M
SM
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.
Kaban
Leonard B
LB
Donoff
R Bruce
RB
Dodson
Thomas B
TB
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D015331:Cohort Studies; D003390:Cranial Nerve Neoplasms / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008036:Lingual Nerve / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008340:Mandibular Nerve / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009463:Neuroma / Q000209:etiology; D010146:Pain / Q000503:physiopathology; D011183:Postoperative Complications; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012677:Sensation / Q000502:physiology*; D013697:Thermosensing / Q000502:physiology; D013997:Time Factors; D014110:Touch / Q000502:physiology; D016896:Treatment Outcome