A Modified Technique of Mandibular Ramus Sagittal Split Osteotomy for Prevention of Inferior Alveolar Nerve Injury A Prospective Cohort Study and Outcome Assessment

作者：Chortrakarnkij Peerasak; Lonic Daniel; Lin Hsiu Hsia; Yamaguchi Kazuaki; Kim Sun Goo; Lo Lun Jou^*

来源：Annals of Plastic Surgery, 2017, 78: S108-S116.

DOI：10.1097/SAP.0000000000001015

• inferior alveolar nerve
• bilateral sagittal split osteotomy
• neurosensory disturbance
• orthognathic surgery

Background: Postoperative functional impairment of the inferior alveolar nerve (IAN) has been a common and well-recognized complication. Our study introduced a modified Obwegeser-Dal Pont bilateral sagittal split osteotomy (BSSO) technique and evaluated the subsequent incidence of postoperative neurosensory disturbance of IAN.
Methods: In this prospective cohort study, 57 patients receiving our modified BSSO during orthognathic surgery were enrolled. The technique contained opening the 2 ramus cortices and inserting the osteotome bypassing the IAN to avoid nerve injury. A 5-point scale self-assessment questionnaire was used to evaluate IAN neurosensory disturbance one week, six months and 12 months postoperatively. Differences between groups were analyzed using chi(2) test for categorical and Wilcoxon signed-rank test for pairwise categorical data.
Results: Complete ramus splitting could be achieved in 109 (95.6%) sides. Lower lip or chin neurosensory disturbances presented in 72 (63.2%) sides 1 week postoperatively and gradually reduced to 9 (7.9%), and 4 (3.5%) at postoperative months 6 and 12, respectively.
Conclusions: This BSSO technique could be safely performed with low rates of IAN exposure and injury and a low incidence of persistent neurosensory disturbance in 3.5% of patients 12 months postoperatively.

• 出版日期2017-3
• 单位长春大学