Kenji Seo1, Yutaka Tanaka, Makoto Terumitsu, Genji Someya. 1. Division of Dental Anesthesiology, Department of Tissue Regeneration, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata City 951-8514, Japan. seo@dent.niigata-u.ac.jp
Abstract
PURPOSE: Steroid hormones are therapeutic for motor and/or sensory dysfunctions caused by nerve injury. However, the timing for giving such medicine is unclear. This study aimed to estimate the efficacy of steroid treatment and determine an appropriate start time after sensory impairment. PATIENTS AND METHODS: Twenty-seven patients with sensory impairment who receivedorthognathic surgery were classified into groups called 1W (n = 6), 3W (n = 6), or 6W (n = 8) group on the basis of start time for steroid treatment, being 1 week, 3 weeks, or 6 weeks after surgery, respectively, and a no steroid treatment (NST) group (a control group) (n = 6) that did not receive treatment for 10 to 12 weeks after surgery. Sensory impairment was diagnosed if postoperative first week mechanical-touch threshold was over 4.0 as measured by Semmes aesthesiometer. Prednisolone treatment was administered orally to patients at 30 mg for 7 days, 15 mg for 4 days, and 5 mg for 3 days. Mechanical-touch threshold and thermal perceptions were compared before and after treatment. RESULTS: At 1 week postoperatively, there were no significant differences in mechanical-touch threshold among the 4 groups (analysis of variance, P >.05). Changes in mechanical-touch threshold in the 1W group showed no significant improvement (analysis of variance, P >.05), but in the 3W and 6W groups, there were significant differences compared with the NST group (Dunns methods, P <.05). CONCLUSIONS:Steroid treatment for sensory impairment after orthognathic surgery has the potential to accelerate recovery and it appears desirable to start treatment later than 1 week postoperatively.
RCT Entities:
PURPOSE:Steroid hormones are therapeutic for motor and/or sensory dysfunctions caused by nerve injury. However, the timing for giving such medicine is unclear. This study aimed to estimate the efficacy of steroid treatment and determine an appropriate start time after sensory impairment. PATIENTS AND METHODS: Twenty-seven patients with sensory impairment who received orthognathic surgery were classified into groups called 1W (n = 6), 3W (n = 6), or 6W (n = 8) group on the basis of start time for steroid treatment, being 1 week, 3 weeks, or 6 weeks after surgery, respectively, and a no steroid treatment (NST) group (a control group) (n = 6) that did not receive treatment for 10 to 12 weeks after surgery. Sensory impairment was diagnosed if postoperative first week mechanical-touch threshold was over 4.0 as measured by Semmes aesthesiometer. Prednisolone treatment was administered orally to patients at 30 mg for 7 days, 15 mg for 4 days, and 5 mg for 3 days. Mechanical-touch threshold and thermal perceptions were compared before and after treatment. RESULTS: At 1 week postoperatively, there were no significant differences in mechanical-touch threshold among the 4 groups (analysis of variance, P >.05). Changes in mechanical-touch threshold in the 1W group showed no significant improvement (analysis of variance, P >.05), but in the 3W and 6W groups, there were significant differences compared with the NST group (Dunns methods, P <.05). CONCLUSIONS:Steroid treatment for sensory impairment after orthognathic surgery has the potential to accelerate recovery and it appears desirable to start treatment later than 1 week postoperatively.