IMPAIRMENT OF THE INFERIOR ALVEOLAR NERVE AFTER SAGITTAL SPLIT OSTEOTOMY
IMPAIRMENT OF THE INFERIOR ALVEOLAR NERVE AFTER SAGITTAL SPLIT OSTEOTOMY
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DOI：
10.1016/s1010-5182(89)80095-2
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发表时间：
1989-08-01
影响因子：
3.1
通讯作者：
HANADA, K
中科院分区：
文献类型：
--
作者：
YOSHIDA, T;NAGAMINE, T;HANADA, K
采用主观症状、轻触、麻醉计和两点辨别等方法，对23例46侧行双侧矢状劈开截骨术患者的下牙槽神经感觉障碍的发生率、程度及其恢复过程进行了研究。根据麻醉仪测试的阈值压力将干扰程度分为轻度、中度和重度。干扰，这是几乎完全限于轻度（37%）和严重（28%）的等级，观察到在67%的样品在一周。大多数轻度病变部位在术后1 ~ 3个月内完全消失，半数重度病变部位在术后3个月~ 1年内完全消失。虽然在另一半的严重干扰网站的恢复被推迟，在一年半的干扰是轻度的。1年时的总体干扰发生率为15%。升支的计算机断层扫描检查显示，下颌管和颊侧皮质板之间的最宽宽度范围为0 mm至3.2 mm，平均值为1.6 ± 1.0 mm。0.9 91%的重度扰动样地土壤侵蚀量小于1.2mm，而无扰动样地和轻度、中度扰动样地土壤侵蚀量分布在0.9 ~ 3.2mm之间。强调术前计算机断层扫描的重要性，以表明下颌管的位置和使用薄骨水泥抹刀截骨，以避免或减少术后发展的感觉神经损伤。
The incidence and degree of neurosensory disturbance of the inferior alveolar nerve, as well as its recovery course, were studied on 46 sides in 23 patients who had undergone bilateral sagittal split osteotomies, by means of subjective symptoms, light touch, anaesthesiometer and two-point discrimination. The degree of disturbance was classified into mild, moderate and severe grades by the threshold pressure shown in tests with the anaesthesiometer. The disturbance, which was almost exclusively limited to mild (37%) and severe (28%) grades, was observed in 67% of the sample at one week. The disturbance disappeared completely within one to three months postoperatively in most sites with mild disturbance, and within three months to one year in half of the severely affected sites. Although the recovery was delayed in the other half of the severely disturbed sites, the disturbance was of mild grade at one and a half years. The overall incidence of disturbance at one year was 15%. Computed tomographic examination of the ascending ramus showed that the narrowest width between the mandibular canal and the buccal cortical plate ranged from 0 mm to 3.2 mm with a mean of 1.6 .+-. 0.9 mm (SD) and it was less than 1.2 mm in 91% of sites with a severe grade disturbance, whereas it was distributed in a range of 0.9 mm to 3.2 mm in sites with no disturbance or with mild or moderate disturbance. The importance of preoperative computed tomography to indicate the location of the mandibular canal and the use of a thin cement spatula for the osteotomy was stressed, to avoid or reduce postoperative development of neurosensory impairment.