title: Reconstruction of the inferior alveolar nerve with bioabsorbable polyglycolic acid nerve conduits.
abstract: BACKGROUND
  Iatrogenic injury to the inferior alveolar nerve can result in debilitating anesthesia, dysesthesia, and allodynia. The authors report their experience with polyglycolic acid nerve tubes in inferior alveolar nerve reconstruction.
  
  
  METHODS
  Five patients with iatrogenically injured inferior alveolar nerves underwent reconstruction with polyglycolic acid nerve tubes performed by the senior author (A.P.T.). Patient charts were reviewed retrospectively. Resolution of pain, narcotic medication use, neuropathic pain medication use, and patient satisfaction with surgery were assessed by means of patient surveys. Sensation recovery was assessed with the Ten Test. Costs of surgery were calculated and adjusted to 2010 U.S. dollars using the consumer price index.
  
  
  RESULTS
  Survey response rate was 100 percent. All patients suffered from preoperative pain and sensation loss. Preoperatively, 80 percent of patients used prescription narcotic and 100 percent of patients used neuropathic pain medications. Average time from injury to reconstruction was 14 months. Operative time averaged 240 minutes, and total surgical costs averaged $8177. At average follow-up of 47.8 months, Ten Test results averaged 3.3. Average time to maximum recovery of sensation and reduction of pain was 8 months and 7 months, respectively. One hundred percent of patients experienced pain relief, with an average 46 percent reduction in pain. Postoperatively, 100 percent of patients discontinued all narcotic and neuropathic pain medications.
  
  
  CONCLUSIONS
  The use of polyglycolic acid nerve tubes in the reconstruction of iatrogenically injured inferior alveolar nerves achieves diminution of pain and variable sensory recovery. This technique is cost effective and carries no donor-site morbidity.
  
  
  METHODS
  : Therapeutic, IV.
authors.affiliation: Baltimore, Md.; Seattle, Wash.; and Dallas, Texas From the Department of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins Hospital; Division of Plastic Surgery, University of Washington; and Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Gerhard S
authors.initials: GS
authors.lastname: Mundinger
authors.forename: Roni B
authors.initials: RB
authors.lastname: Prucz
authors.forename: Shai M
authors.initials: SM
authors.lastname: Rozen
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Tufaro
mesh_terms: D000328:Adult; D000368:Aged; D003757:Dental Implantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008340:Mandibular Nerve / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D010148:Intractable Pain / Q000209:etiology; D011100:Polyglycolic Acid; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000009:adverse effects
chemical_list: D011100:Polyglycolic Acid