Sensory retraining following orthognathic surgery: effect on threshold measures of sensory function.
The purpose of this analysis was to examine the effect of sensory retraining on sensory function after bilateral sagittal split osteotomy (BSSO). A total of 186 subjects were enrolled in a multi-centre double-blind two parallel group stratified block randomized clinical trial. Subjects were randomized to group immediately after surgery. Threshold measures for contact detection, two-point discrimination and two-point perception were obtained on the chin before and 1, 3 and 6 months and 1 and 2 years after surgery. The ratio of each threshold measure (post-surgery value/pre-surgery value) was calculated to characterize subjects' impairment. A general linear mixed model was fit for the impairment to examine the effect of the sensory retraining before and after adjusting for demographic, surgical and psychological factors. On average, two-point perception was less impaired in subjects who were retrained than in those who were not retrained (P = 0.04). Significant recovery continued up to 6 months after surgery for contact detection and two-point perception and up to 24 months for two-point discrimination. Older subjects experienced more impairment in two-point discrimination than younger subjects (P = 0.009). Subjects who received maxillary surgery in addition to mandibular surgery experienced more impairment on the chin in both two-point discrimination (P = 0.0003) and perception (P = 0.0013) than subjects who received mandibular surgery only. Psychological factors did not explain additional variability in subjects' impairment post-surgery. These finding indicate that a simple non-invasive exercise programme initiated shortly after orthognathic surgery can alter the way patients experience or respond to tactile stimulation long after the exercise regimen has stopped.
Department of Prosthodontics, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7450, USA. greg_essick@dentistry.unc.edu
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D000328:Adult; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005157:Facial Pain / Q000534:rehabilitation* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000534:rehabilitation*; D020127:Recovery of Function; D012677:Sensation / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000503:physiopathology*; D061221:Trigeminal Nerve Injuries