title: Neurosensory disturbances one year after bilateral sagittal split osteotomy of the mandibula performed with separators: a multi-centre prospective study.
abstract: Bilateral sagittal split osteotomy (BSSO) is an effective and commonly used treatment to correct mandibular hypo- and hyperplasia. Hypoesthesia of the inferior alveolar nerve (IAN) is a common complication of this surgical procedure. This prospective multi-centre study aimed to determine the incidence of neurosensory disturbances of the IAN after BSSO procedures performed without the use of chisels. Our study group comprised 158 patients, with a follow-up period of 1 year, who underwent BSSO (with or without Le Fort I) that incorporated the use of sagittal split separators and splitters but no chisels. The percentage of BSSO split procedures that resulted in IAN damage was 5.1%. The percentage of patients (without genioplasty) who experienced IAN damage was 8.9%. The concomitant genioplasty in combination with BSSO was significantly associated with hypoesthesia. Peri-operative removal of the wisdom tooth or a Le Fort I procedure did not influence post-operative hypoesthesia. We believe that the use of splitting forceps and elevators without chisels leads to a lower incidence of persistent post-operative hypoesthesia 1 year after BSSO of the mandible, without increasing the risk of a bad split.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Leiden University Medical Centre, Leiden, The Netherlands. GMensink1@amphia.nl
authors.forename: Gertjan
authors.initials: G
authors.lastname: Mensink
authors.forename: Albert
authors.initials: A
authors.lastname: Zweers
authors.forename: Ron
authors.initials: R
authors.lastname: Wolterbeek
authors.forename: Gertjan G J
authors.initials: GG
authors.lastname: Dicker
authors.forename: Robert H
authors.initials: RH
authors.lastname: Groot
authors.forename: Richard J P R
authors.initials: RJ
authors.lastname: van Merkesteyn
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001863:Bone Screws; D002610:Cheek / Q000294:innervation; D002680:Chin / Q000601:surgery; D003389:Cranial Nerve Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005546:Forehead / Q000294:innervation; D006801:Humans; D006987:Hypesthesia / Q000209:etiology*; D008046:Lip / Q000294:innervation; D008297:Male; D008334:Mandible / Q000294:innervation / Q000601:surgery*; D019186:Mandibular Advancement / Q000009:adverse effects / Q000295:instrumentation; D008340:Mandibular Nerve / Q000503:physiopathology*; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000009:adverse effects* / Q000295:instrumentation; D011446:Prospective Studies; D014081:Tooth Extraction / Q000379:methods; D014110:Touch / Q000502:physiology; D061221:Trigeminal Nerve Injuries / Q000209:etiology; D055815:Young Adult