Lingual nerve sensory outcomes of non-grafted microsurgery using platelet rich plasma: retrospective study

Abstract

Background: Lingual nerve injury can occur through a multitude of etiologies. Platelet Rich Plasma has been studied since the 1990s and it is known that platelets are capable of secreting growth factors. The purpose of the study is to evaluate the effect of platelet rich plasma (PRP) on functional sensory recovery and time to recovery following lingual nerve microsurgery. Methods: All patients had lingual nerve microsurgery and neurosensory testing performed by surgeon between 2015 and 2019. Description of procedures performed, sensory testing, and patient information were obtained by a retrospective review of hospital records and office charts after institutional review board approval (reference number CR00003274). Those patients who underwent lingual nerve microsurgery (primary neurorrhaphy with-out use of nerve grafts) with and without the use of PRP during this study period were included. The functional sensory recovery was determined by subjective and objective neurosensory testing. The objective findings were correlated to a Medical Research Council System score, with grades S2, S2+, S3, S3+, and S4. Functional Sensory Recovery was determined at S3, S3+, and S4. Results: The effect of PRP on sensory recovery for lingual nerve microsurgery was compared to the group without platelet rich plasma using a non-parametric tests (Mann Whitney U test). The mean total functional sensory recovery achieved was functional sensory recovery S3+. Follow-up time was from 3 to 18 months (mean, 9.32 months; SD, 3.67 months). The follow-up time until achieving functional sensory recovery was 5.5 months for the PRP group and 9.5 for the non-PRP group. Conclusions: Although there were no statistical differences in neurosensory testing between the 2 groups studied, the time to achieve functional sensory recovery was expedited in the PRP group. Due to the small incremental improvements with or without the use of PRP; no significant differences between the groups were noted except in time to functional sensory recovery with the PRP group showing shorter duration. The shorter duration to functional sensory recovery with the use of PRP was statistically significant and clinically relevant.