Orthognathic surgery-related nerve injuries: analysis and treatment modalities

TL;DR

This study examines nerve injuries after orthognathic surgery and evaluates treatment outcomes, suggesting low-level laser therapy may help recovery.

Contribution

The study provides real-world data on incidence and treatment of trigeminal nerve injuries after orthognathic surgery.

Findings

17 nerve injuries were identified in 287 patients based on postoperative sensory complaints.

Low-level laser therapy (LLLT) showed potential therapeutic benefits for neurosensory recovery.

Complete neurosensory recovery remains challenging despite various treatment modalities.

Abstract

Background: Orthognathic surgery, while highly effective in correcting
dentofacial deformities, inherently poses a risk of neurosensory complications.
Despite the growing volume of these surgical procedures, real-world data remain
limited concerning the precise incidence, clinical course, and efficacy of
various therapeutic interventions for nerve injuries in this specific context.
This study aims to delineate the incidence, anatomical distribution, and
treatment outcomes of trigeminal nerve injuries observed after orthognathic
surgery within a tertiary care center. Methods: This retrospective
cohort study involved 287 patients who underwent orthognathic surgical
procedures. Data, including demographic, surgical, and follow-up course, were
extracted from electronic medical records. Nerve injuries were specifically
identified based on documented postoperative sensory complaints localized to the
distribution of the maxillary (CN V2) or mandibular (CN V3) divisions of the
trigeminal nerve. Data regarding post-operative treatment using different
modalities were collected and analyzed. Results: Our
retrospective review identified 17 nerve injuries based on documented
postoperative sensory complaints within the CN V2 or CN V3 distributions. The
various treatment modalities employed included low-level laser therapy (LLLT),
corticosteroids, and vitamin B supplementation. Detailed outcomes regarding the
incidence and distribution of these injuries were analyzed. Conclusions:
Post-orthognathic surgery trigeminal neurosensory deficits, while not common, are
clinically significant. Our findings suggest that LLLT may offer a therapeutic
advantage in managing these deficits, though achieving complete neurosensory
recovery remains a challenge.

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