How do I expose the inferior alveolar nerve for microneurosurgical repair?

Q3 Dentistry Oral and Maxillofacial Surgery Cases Pub Date : 2024-02-17 DOI:10.1016/j.omsc.2024.100349

Michael Miloro

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Abstract

This technical note describes an innovation that addresses a clinical problem in iatrogenic inferior alveolar nerve (IAN) repair. The options for IAN exposure (Miloro, 1995) are less than ideal since they offer limited access and visibility and/or the exposure itself has a risk of inducing iatrogenic IAN injury. This technical note offers the option to perform IAN exposure via a unilateral sagittal split osteotomy (SSO). There are inherent risks of mild transient IAN paresthesia, malocclusion, bad splits, and the additional cost of rigid fixation hardware (Peleg et al., 2021). The significance of this technique is that it permits wide access for IAN reconstruction in cases where the IAN injury is in the posterior mandible (eg. due to mandibular third molar removal) where another option for access is limited. This technique will improve patient care by facilitating IAN exposure and repair. There should be no challenges or delays to implementing this innovation for surgeons who perform orthognathic surgery and nerve repair.

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如何暴露下牙槽神经进行显微神经外科修复？

本技术说明介绍了一项创新技术，该技术解决了先天性下牙槽神经（IAN）修复的临床问题。暴露下牙槽神经（IAN）的方法（Miloro，1995 年）并不理想，因为它们提供的通道和可视性有限，并且/或者暴露本身有诱发下牙槽神经先天性损伤的风险。本技术说明提供了通过单侧矢状面劈开截骨术（SSO）进行 IAN 暴露的选择。该方法存在轻度一过性 IAN 麻痹、咬合不正、劈裂不良以及刚性固定硬件额外费用等固有风险（Peleg 等人，2021 年）。该技术的重要意义在于，当 IAN 损伤位于下颌后部（例如，由于下颌第三磨牙切除术），而其他入路选择有限时，该技术可为 IAN 重建提供宽阔的入路。这项技术将有助于 IAN 的暴露和修复，从而改善对患者的护理。对于进行正颌外科手术和神经修复的外科医生来说，实施这项创新技术应该不会遇到任何挑战或延误。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral and Maxillofacial Surgery Cases Medicine-Otorhinolaryngology

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

69 days

期刊介绍： Oral and Maxillofacial Surgery Cases is a surgical journal dedicated to publishing case reports and case series only which must be original, educational, rare conditions or findings, or clinically interesting to an international audience of surgeons and clinicians. Case series can be prospective or retrospective and examine the outcomes of management or mechanisms in more than one patient. Case reports may include new or modified methodology and treatment, uncommon findings, and mechanisms. All case reports and case series will be peer reviewed for acceptance for publication in the Journal.