Intraoperative Computed Tomography in Bilateral Sagittal Split Osteotomy.
OBJECTIVE
The objective of the study was to show the importance of intraoperative computed tomography as an aid for ensuring inferior alveolar nerve safety during bilateral sagittal split osteotomy.


METHODS
This study included ten patients who underwent bilateral sagittal split osteotomy procedure. All patients were treated for orthognathic reasons. The unerupted lower third molars, if present, were removed at least 6 months prior to Sagittal Split Osteotomy. The Sagittal Split Osteotomy surgical technique was previously described in detail. Each patient underwent computed tomography with an Artis Zeego multi-axis system (Siemens AG, Healthcare Sector, Henkestrasse 127 D-91052 Erlangen, Germany) at the beginning of the operation and immediately after placement of the osteosynthesis plates and screws. The neurosensory tests consisted of a light touch test using the 5.07/10-g Semmes Weinstein monofilament (Stoelting Co, Wood Dale, IL), and patient self-reporting.


RESULTS
Eight (80 %) patients presented with hypoesthesia of lower lip at 6 weeks follow up. At 6 month follow up only two patients (20 %) presented with diminished sensation in the lower lip. Labial sensibility was normal in all patients at the last follow-up visit.


CONCLUSIONS
Intraoperative computed tomography enables immediate assessment of treatment and the option to modify the treatment if necessary. Our results indicate that intra-operative computed tomography would be a helpful procedure during orthognathic surgery to improve the postoperative health of the inferior alveolar nerve.
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium.
Jimoh Olubanwo
JO
Agbaje
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium ; Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Ahmed Sobhy
AS
Salem
Faculty of Medicine, Hasselt University, Diepenbeek, Belgium.
Ivo
I
Lambrichts
Department of Oral and Maxillofacial Surgery, ZNA Middelheim, Antwerp, Belgium.
Luc
L
Daems
Department of Oral and Maxillofacial Surgery, Mariaziekenhuis Noord-Limburg, Overpelt, Belgium.
Paul
P
Legrand
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium ; Faculty of Medicine, Hasselt University, Diepenbeek, Belgium.
Constantinus
C
Politis
Computed tomography; Inferior alveolar nerve; Orthognathic surgery; Osteotomy; Sagittal split ramus