Neurosensory Disturbance in Patients Undergoing Mandibular Setback- A Comparative Study Between Bilateral Sagittal Split Osteotomy (BSSO) and Intraoral Vertical Sagittal Ramus Osteotomy (IVSRO)

• Main Author: Thomas, Nissy Susan
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2018
• Subjects: Agronomy; Asymmetry; Cotton; Dentistry; Injuries; Maxillofacial surgery; Medical imaging; Medical prognosis; Pain; Patients; Quality of life; Surgery; Tomography
• ISBN: 9798380246118

BACKGROUND AND OBJECTIVES:The aim of the study was comparative evaluation of incidenceof neurosensory deficiencies in Bilateral sagittal split osteotomies and Intraoral vertical sagittal ramus osteotomy.METHODOLOGY:30 adult patients who have undergone mandibular setback at least 1 year ago through bilateral sagittal split osteotomy/intraoral vertical sagittal ramus osteotomy The patients details and findings of examinations were noted on a specifically designed performa which included a questionnaire to be answered by the patients about neurosensory disturbances in the distribution of inferior alveolar nerve, duration and any altered quality of life, along with the following tests•Two point discrimination•Directional discrimination•Contact Detection•Sharp and Blunt DiscriminationRESULTS:Based on subjective evaluation altered sensation (numbness) was experienced in 26.7% (8 case) in IVSRO during immediate postoperative period where as nil altered sensation after 1 year. But all the patients had altered sensation following BSSO procedure, of which numbness was persistent in 40% (12 case) and pinching sensation in 10% (3 cases) at 1 year postoperatively. Findings from the subjective evaluation was confirmed following the objective evaluation using various neurosensory tests and contact detection using Semmes Weinstein Monofilament.CONCLUSION: On the basis of these assessments we have observed that IVSROwas associated with lesser degree of NSD as compared to BSSO, as equal to nil at the end of 1 year compared to 100% NSD which is associated with BSSO, the reason for a lower incidence of neurologic injury, is the ease of avoidance of the nerve by keeping the osteotomy posterior to the mandibular foramen.