Does early repair of lingual nerve injuries improve functional sensory recovery?
OBJECTIVE
This study evaluated the relationship between timing of lingual nerve repair and functional sensory recovery.


METHODS
Using a retrospective cohort study design, the investigators enrolled a sample of subjects who had lingual nerve repair. The predictor variable was time between injury and repair, categorized as early (<90 days after injury) or late (>90 days after injury). The outcome variable was the time to functional sensory recovery (FSR), measured in days. Other variables were categorized as demographic, anatomic, and operative. Uni- and multivariate Cox proportional hazards models were used to evaluate the association between the timing of the repair and time to FSR.


RESULTS
The study sample was composed of 64 subjects who had lingual nerve repair between January 1998 and January 2005. The mean time between injury and repair was 153.2 (31-1606) days; 21.9% of subjects had early repair. The mean age was 28.4 +/- 8.0 years, 62.5% of subjects were female; 77% of the injured nerves were repaired by direct suture, and 23% had surgical exploration with decompression/neurolysis. In bivariate analyses, early repair, method of repair, and neuroma were statistically or near-statistically associated with time to FSR (P <or= .12). In a multiple Cox proportional hazards model, early repair was associated with time to FSR (P = .02). Ninety-three percent of subjects in the early repair group achieved FSR within 1 year, compared with 62.9% in the late group (P = .05).


CONCLUSIONS
Early repair of lingual nerve injuries results in FSR more frequently and earlier than late repair.
Susarla
Srinivas M
SM
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
Kaban
Leonard B
LB
Donoff
R Bruce
RB
Dodson
Thomas B
TB
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008036:Lingual Nerve / Q000503:physiopathology / Q000601:surgery; D061222:Lingual Nerve Injuries; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer; D009437:Neuralgia / Q000601:surgery; D009463:Neuroma / Q000601:surgery; D016016:Proportional Hazards Models; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D012677:Sensation / Q000502:physiology*; D012678:Sensation Disorders / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome