Nerve Repair

Trigeminal nerve repair explores and repairs significant injuries to injured trigeminal nerve branches: the inferior alveolar nerve (IAN), the lingual nerve (LN), and the infraorbital nerve (ION). For lingual nerve repair, a sandbag is placed under the patient's shoulders to elevate the mandible. The skin and oral cavity are prepped, and local anesthetic containing epinephrine is injected within the operation site for pain control and hemostasis. A modified Dingman mouth gag is utilized to position the mouth open, using the tongue blade to keep the tongue away from the operative site. For a great auricular nerve graft the surgeon sits on the same side as the donor neck, and the patient's head is turned to the opposite side. The possibility of donor nerve graft and the choice of donor site and side, including the risks of nerve grafting, should be discussed with the patient prior to surgery.