TY - JOUR
T1 - Reconstruction of the inferior alveolar nerve with bioabsorbable polyglycolic acid nerve conduits
AU - Mundinger, Gerhard S.
AU - Prucz, Roni B.
AU - Rozen, Shai M.
AU - Tufaro, Anthony P.
PY - 2012/1
Y1 - 2012/1
N2 - BACKGROUND: Iatrogenic injury to the inferior alveolar nerve can result in debilitating anesthesia, dysesthesia, and allodynia. The authors report their experience with polyglycolic acid nerve tubes in inferior alveolar nerve reconstruction. METHODS: Five patients with iatrogenically injured inferior alveolar nerves underwent reconstruction with polyglycolic acid nerve tubes performed by the senior author (A.P.T.). Patient charts were reviewed retrospectively. Resolution of pain, narcotic medication use, neuropathic pain medication use, and patient satisfaction with surgery were assessed by means of patient surveys. Sensation recovery was assessed with the Ten Test. Costs of surgery were calculated and adjusted to 2010 U.S. dollars using the consumer price index. RESULTS: Survey response rate was 100 percent. All patients suffered from preoperative pain and sensation loss. Preoperatively, 80 percent of patients used prescription narcotic and 100 percent of patients used neuropathic pain medications. Average time from injury to reconstruction was 14 months. Operative time averaged 240 minutes, and total surgical costs averaged $8177. At average follow-up of 47.8 months, Ten Test results averaged 3.3. Average time to maximum recovery of sensation and reduction of pain was 8 months and 7 months, respectively. One hundred percent of patients experienced pain relief, with an average 46 percent reduction in pain. Postoperatively, 100 percent of patients discontinued all narcotic and neuropathic pain medications. CONCLUSIONS: The use of polyglycolic acid nerve tubes in the reconstruction of iatrogenically injured inferior alveolar nerves achieves diminution of pain and variable sensory recovery. This technique is cost effective and carries no donor-site morbidity.
AB - BACKGROUND: Iatrogenic injury to the inferior alveolar nerve can result in debilitating anesthesia, dysesthesia, and allodynia. The authors report their experience with polyglycolic acid nerve tubes in inferior alveolar nerve reconstruction. METHODS: Five patients with iatrogenically injured inferior alveolar nerves underwent reconstruction with polyglycolic acid nerve tubes performed by the senior author (A.P.T.). Patient charts were reviewed retrospectively. Resolution of pain, narcotic medication use, neuropathic pain medication use, and patient satisfaction with surgery were assessed by means of patient surveys. Sensation recovery was assessed with the Ten Test. Costs of surgery were calculated and adjusted to 2010 U.S. dollars using the consumer price index. RESULTS: Survey response rate was 100 percent. All patients suffered from preoperative pain and sensation loss. Preoperatively, 80 percent of patients used prescription narcotic and 100 percent of patients used neuropathic pain medications. Average time from injury to reconstruction was 14 months. Operative time averaged 240 minutes, and total surgical costs averaged $8177. At average follow-up of 47.8 months, Ten Test results averaged 3.3. Average time to maximum recovery of sensation and reduction of pain was 8 months and 7 months, respectively. One hundred percent of patients experienced pain relief, with an average 46 percent reduction in pain. Postoperatively, 100 percent of patients discontinued all narcotic and neuropathic pain medications. CONCLUSIONS: The use of polyglycolic acid nerve tubes in the reconstruction of iatrogenically injured inferior alveolar nerves achieves diminution of pain and variable sensory recovery. This technique is cost effective and carries no donor-site morbidity.
UR - http://www.scopus.com/inward/record.url?scp=84555191824&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84555191824&partnerID=8YFLogxK
U2 - 10.1097/PRS.0b013e3182362a87
DO - 10.1097/PRS.0b013e3182362a87
M3 - Article
C2 - 22186525
AN - SCOPUS:84555191824
SN - 0032-1052
VL - 129
SP - 110e-117e
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 1
ER -