Mette Hørberg1, Jesper Reibel2, Camilla Kragelund3. 1. Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, The Capital Region of Denmark, Denmark. 2. Oral Pathology and Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, 20, Norre Allé, DK-2200, Copenhagen N, Denmark. 3. Oral Pathology and Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, 20, Norre Allé, DK-2200, Copenhagen N, Denmark. ckra@sund.ku.dk.
Abstract
OBJECTIVE: Micro-neurosurgical repair is considered in permanent nerve damage but the outcome is unpredictable. We examined if histopathologic parameters of traumatic neuromas have a prognostic value for recovery in relation to lingual nerve micro-neurosurgery. MATERIALS AND METHODS: Retrospective case study on neurosensory recovery after micro-neurosurgery. Outcome variables were as follows: pain perception, two-point discrimination, and sum score of perception, before and 12 months after micro-neurosurgery. Predictive histopathology variables included size, nerve tissue, and inflammation. Statistics are as follows: logistic and correlation analyses (P < 0.05). RESULTS: Sixty-five patients with lingual nerve damage were included in the study. Improved two-point discrimination was associated with small size of resected tissue (P = 0.0275). No normal appearing distal nerve tissue was associated with improved sum score of perception (P = 0.0185), higher final sum score of perception value (P = 0.0475) and final pain perception (P = 0.0324). Foreign body reaction was associated with no final pain perception (P = 0.0492). CONCLUSIONS: Small size, absence of distal nerve tissue, and no foreign body reaction were associated with improvement of the neurosensory functions. CLINICAL RELEVANCE: Histological parameters of the traumatic neuromas in routine preparation appeared to have some prognostic value for neurosensory functions as improvement of the neurosensory functions was associated with small size of resected tissue, no distal normal appearing nerve tissue, and no foreign body reaction.
OBJECTIVE: Micro-neurosurgical repair is considered in permanent nerve damage but the outcome is unpredictable. We examined if histopathologic parameters of traumatic neuromas have a prognostic value for recovery in relation to lingual nerve micro-neurosurgery. MATERIALS AND METHODS: Retrospective case study on neurosensory recovery after micro-neurosurgery. Outcome variables were as follows: pain perception, two-point discrimination, and sum score of perception, before and 12 months after micro-neurosurgery. Predictive histopathology variables included size, nerve tissue, and inflammation. Statistics are as follows: logistic and correlation analyses (P < 0.05). RESULTS: Sixty-five patients with lingual nerve damage were included in the study. Improved two-point discrimination was associated with small size of resected tissue (P = 0.0275). No normal appearing distal nerve tissue was associated with improved sum score of perception (P = 0.0185), higher final sum score of perception value (P = 0.0475) and final pain perception (P = 0.0324). Foreign body reaction was associated with no final pain perception (P = 0.0492). CONCLUSIONS: Small size, absence of distal nerve tissue, and no foreign body reaction were associated with improvement of the neurosensory functions. CLINICAL RELEVANCE: Histological parameters of the traumatic neuromas in routine preparation appeared to have some prognostic value for neurosensory functions as improvement of the neurosensory functions was associated with small size of resected tissue, no distal normal appearing nerve tissue, and no foreign body reaction.
Authors: W Jerjes; B Swinson; D R Moles; M El-Maaytah; B Banu; T Upile; M Kumar; M Al Khawalde; M Vourvachis; H Hadi; S Kumar; C Hopper Journal: Oral Surg Oral Med Oral Pathol Oral Radiol Endod Date: 2006-08-04
Authors: Shahrokh C Bagheri; Roger A Meyer; Husain Ali Khan; Amy Kuhmichel; Martin B Steed Journal: J Oral Maxillofac Surg Date: 2009-12-29 Impact factor: 1.895