title: Nerve Sharing Between the Lingual and Mental Nerve to Restore Lower Lip Sensation After Segmental Resection of the Mandible.
abstract: This report demonstrates a successful new procedure for reconstructing the inferior alveolar nerve by transplanting the great auricular nerve (GAN) between the mental nerve and the remaining submandibular ganglion to achieve nerve sharing of the lingual nerve. A 59-year-old woman with discomfort in the left mandibular retromolar region and ipsilateral neck was referred to our hospital by a local dentist. Physical examination showed mild swelling and redness at the left mandibular retromolar region. The histologic diagnosis showed central mucoepidermoid carcinoma of the jaw. With the patient under general anesthesia, segmental resection of the mandible followed by level 1 selective neck dissection was performed. The resected mandible was reconstructed with a titanium plate. The submandibular incision was extended to the lower edge of the tragus for harvesting of the GAN. The GAN was grafted, and an epineural neurorrhaphy was carried out with the mental nerve, as well as the submandibular ganglion, under a microscope. After the operation, submental sensation was evaluated with a Semmes-Weinstein pressure esthesiometer. The Semmes-Weinstein pressure esthesiometer test showed a loss of perception at the third week after surgery. Within 12 months, nerve sensation was substantially improved and the patient was free from discomfort.
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Tokyo, Japan. Electronic address: murata11@wonder.ocn.ne.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Murata
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: Harutsugi
authors.initials: H
authors.lastname: Abukawa
authors.affiliation: Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Satomi
authors.affiliation: Professor and Chair, Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Daichi
authors.initials: D
authors.lastname: Chikazu
mesh_terms: D018277:Carcinoma, Mucoepidermoid / Q000601:surgery*; D003389:Cranial Nerve Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008036:Lingual Nerve / Q000601:surgery*; D008046:Lip / Q000294:innervation*; D008339:Mandibular Neoplasms / Q000601:surgery*; D008340:Mandibular Nerve / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D012677:Sensation; D014057:Tomography, X-Ray Computed