Outcome following lingual nerve repair with vein graft cuff: a preliminary report.

Abstract

PURPOSE:

The object of this study was to assess the effects of an inside-out vein graft as a cuff after direct suture on human lingual nerve regeneration and recovery after iatrogenic lingual nerve injury.

PATIENTS AND METHODS:

Ten patients with unilateral lingual nerve anesthesia as a complication of iatrogenic injury after third molar extraction underwent microneurosurgical procedures for the injured lingual nerve under general anesthesia. The patients were randomized into 2 groups. In group A, after removing the neuromas and peripheral scars surrounding the torn nerves, the 2 nerve ends were sutured without tension. In group B, after the same procedure, including the same suturing procedure, an inside-out vein graft was placed as a cuff after the direct suture. Each group was followed at least once every 6 months for 1 year after the procedure. Postoperative outcomes were evaluated using the Pogrel criteria, the Sunderland grade, and the British Medical Research Council Scale (MRCS).

RESULTS:

There were no particular differences between groups A and B at 6 and 12 months after the operation. However, based on the MRCS criteria, there was a clearly better result in group B than in group A at 6 and 12 months after the operation, and the recovery of gustatory sensation tended to be better in group B than in group A 1 year after the operation.

CONCLUSION:

This inside-out vein graft as a cuff after direct suturing may facilitate faster lingual nerve regeneration than the traditional direct suture approach. The inside-out vein graft as a cuff may provide the advantages of preventing axonal escape at the suture lines, minimizing nerve entrapment, and preventing neuroma formation in the space between the sutured nerves.

• Authors: Shigeyuki Fujita, Itaru Tojyo, Masai Yamada, Yoshihiko Go, Takashi Matsumoto, Norifumi Kiga
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 72 Issue 7 Pg. 1433.e1-7 (Jul 2014) ISSN: 1531-5053 [Electronic] United States
• PMID: 24813776 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Female
• Humans
• Lingual Nerve (surgery)
• Male
• Middle Aged
• Molar, Third (surgery)
• Tooth Extraction (adverse effects)
• Treatment Outcome
• Veins (transplantation)
• Young Adult