Neurosensory disturbance of the inferior alveolar nerve after bilateral sagittal split osteotomy: a systematic review. 2007

Giuseppe Colella, and Rosangela Cannavale, and Antonio Vicidomini, and Antonio Lanza
Head and Neck Surgery Department, 2nd University of Naples, Naples, Italy. giuseppe.colella@unina2.it

OBJECTIVE The evaluation of neurosensory disturbance of the inferior alveolar nerve (IAN) can be performed by purely subjective, relatively objective, or purely objective methods. The aim of this study was to provide a systematic review of the incidence of inferior alveolar nerve sensory disturbance after bilateral sagittal split osteotomy, as well as the frequency of recovery of sensory function using objective methods of evaluation only. METHODS Searches were conducted employing MEDLINE, Scirus, and the Cochrane Central Register of Controlled Trials (CENTRAL). Seven studies were included in this review. RESULTS This systematic review has shown that the frequency of nerve impairment evaluated by subjective methods was higher than that indicated by studies adopting objective methods at each time of follow-up considered. In particular at the seventh postoperative day the frequency obtained using the objective methods was 63.3% while that obtained with subjective methods was 83%. At 1 year follow-up a frequency of sensory impairment of 12.8% was obtained using objective methods and a frequency of 18.4% when subjective methods were used. The data were analysed using the index of inter-rater reliability (Cohen's Kappa) with the degree of nerve damage evaluated by objective methods considered the "gold standard." The value of Cohen's Kappa at 1 week follow-up is 0.53; at 1 year follow-up it increased to 0.90. CONCLUSIONS On the basis of these results, objective methods provide the most sensitive diagnostic tests at early controls-within 3 months of the operation. At later control points the sensitivity increases and the inter-rater reliability is satisfactory.

UI MeSH Term Description Entries
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D015588 Observer Variation The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material). Bias, Observer,Interobserver Variation,Intraobserver Variation,Observer Bias,Inter-Observer Variability,Inter-Observer Variation,Interobserver Variability,Intra-Observer Variability,Intra-Observer Variation,Intraobserver Variability,Inter Observer Variability,Inter Observer Variation,Inter-Observer Variabilities,Inter-Observer Variations,Interobserver Variabilities,Interobserver Variations,Intra Observer Variability,Intra Observer Variation,Intra-Observer Variabilities,Intra-Observer Variations,Intraobserver Variabilities,Intraobserver Variations,Observer Variations,Variabilities, Inter-Observer,Variabilities, Interobserver,Variabilities, Intra-Observer,Variabilities, Intraobserver,Variability, Inter-Observer,Variability, Interobserver,Variability, Intra-Observer,Variability, Intraobserver,Variation, Inter-Observer,Variation, Interobserver,Variation, Intra-Observer,Variation, Intraobserver,Variation, Observer,Variations, Inter-Observer,Variations, Interobserver,Variations, Intra-Observer,Variations, Intraobserver,Variations, Observer
D061221 Trigeminal Nerve Injuries Traumatic injuries to the TRIGEMINAL NERVE. It may result in extreme pain, abnormal sensation in the areas the nerve innervates on face, jaw, gums and tongue and can cause difficulties with speech and chewing. It is sometimes associated with various dental treatments. Cranial Nerve V Injury,Fifth Cranial Nerve Injuries,Fifth Cranial Nerve Injury,Fifth-Nerve Palsy, Traumatic,Fifth-Nerve Trauma,Injury, Cranial Nerve V,Injury, Fifth Cranial Nerve,Traumatic Fifth-Nerve Palsy,Trigeminal Nerve Avulsion,Trigeminal Nerve Contusion,Trigeminal Nerve Injury,Trigeminal Nerve Transection,Trigeminal Nerve Trauma,Trigeminal Neuropathy, Traumatic,Avulsion, Trigeminal Nerve,Avulsions, Trigeminal Nerve,Contusion, Trigeminal Nerve,Contusions, Trigeminal Nerve,Fifth Nerve Palsy, Traumatic,Fifth Nerve Trauma,Fifth-Nerve Palsies, Traumatic,Fifth-Nerve Traumas,Injuries, Trigeminal Nerve,Injury, Trigeminal Nerve,Nerve Avulsion, Trigeminal,Nerve Avulsions, Trigeminal,Nerve Contusion, Trigeminal,Nerve Contusions, Trigeminal,Nerve Injuries, Trigeminal,Nerve Injury, Trigeminal,Nerve Transection, Trigeminal,Nerve Transections, Trigeminal,Nerve Trauma, Trigeminal,Nerve Traumas, Trigeminal,Neuropathies, Traumatic Trigeminal,Neuropathy, Traumatic Trigeminal,Palsies, Traumatic Fifth-Nerve,Palsy, Traumatic Fifth-Nerve,Transection, Trigeminal Nerve,Transections, Trigeminal Nerve,Trauma, Fifth-Nerve,Trauma, Trigeminal Nerve,Traumas, Fifth-Nerve,Traumas, Trigeminal Nerve,Traumatic Fifth Nerve Palsy,Traumatic Fifth-Nerve Palsies,Traumatic Trigeminal Neuropathies,Traumatic Trigeminal Neuropathy,Trigeminal Nerve Avulsions,Trigeminal Nerve Contusions,Trigeminal Nerve Transections,Trigeminal Nerve Traumas,Trigeminal Neuropathies, Traumatic
D018865 Dental Research The study of laws, theories, and hypotheses through a systematic examination of pertinent facts and their interpretation in the field of dentistry. (From Jablonski, Illustrated Dictionary of Dentistry, 1982, p674) Research, Dental
D019647 Oral Surgical Procedures Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region. Maxillofacial Procedures,Oral Surgical Procedure,Procedure, Oral Surgical,Procedures, Oral Surgical,Surgical Procedure, Oral,Surgical Procedures, Oral,Maxillofacial Procedure,Procedure, Maxillofacial,Procedures, Maxillofacial
D020127 Recovery of Function A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma. Function Recoveries,Function Recovery
D020209 Cranial Nerve Injuries Dysfunction of one or more cranial nerves causally related to a traumatic injury. Penetrating and nonpenetrating CRANIOCEREBRAL TRAUMA; NECK INJURIES; and trauma to the facial region are conditions associated with cranial nerve injuries. Cranial Neuropathies, Traumatic,Cranial Nerve Injury,Cranial Neuropathy, Traumatic,Injuries, Cranial Nerve,Injury, Cranial Nerve,Nerve Injuries, Cranial,Nerve Injury, Cranial,Neuropathies, Traumatic Cranial,Neuropathy, Traumatic Cranial,Traumatic Cranial Neuropathies,Traumatic Cranial Neuropathy

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