Comparison of lingual and inferior alveolar nerve microsurgery outcomes

Objective: To evaluate the outcomes of published studies involving lingual nerve (LN) and inferior alveolar nerve (IAN) microsurgery and reviewing differences in sensory recovery and timing to repair for both groups. Method and Materials: A total of 29 patient charts referred to the principal investigator were reviewed (15 IAN and 14 LN). Age, gender, mechanism of injury, and time from injury to surgical repair were assessed. Two-point discrimination and tactile detection threshold (via von Frey monofilaments) were the utilized measured variables because both are quantifiable and repeatable data points. Results: There was a predominance of female patients (10 IAN, 12 LN), and the mean age of the patients in the IAN group (37.40 ± 9.61 years) was significantly higher than in the LN group (28.86 ± 7.99 years). The time from injury to microsurgery was longer in the LN group (234.10 ± 166.13 days) than the IAN group (137.80 ± 83.80 days). Four patients from the IAN group and 7 from the LN group were operated on more than 6 months after the injury. Of the 15 patients who underwent IAN microsurgery, 1 patient had no change in either von Frey or 2-point discrimination results after the procedure, and 2 patients had no changes in only von Frey results. For the 14 patients undergoing LN repair, 1 patient demonstrated no change in the 2-point discrimination test and 1 patient had a reduced postoperative von Frey result compared to the preoperative measurement. Conclusion: Patients undergoing LN and IAN microsurgery benefit from trigeminal nerve microsurgery. No statistically significant differences overall were observed when comparing the outcomes of LN and IAN microsurgery. Patients undergoing trigeminal nerve microsurgery for LN and IAN injuries 6 months after injury derived less sensory recovery; however, significant improvement was still observed, warranting consideration for microsurgery in those patients who might present later for initial surgical consultation. Keywords: inferior alveolar nerve, lingual nerve, microsurgery, trigeminal nerve microsurgery