Surgical treatment of painful lesions of the inferior alveolar nerve

Federico Biglioli, Fabiana Allevi, Alessandro Lozza

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Nerve-related complications are being reported with increasing frequency following oral and dental surgery, and typically involve the inferior alveolar nerve (IAN). We assess herein the etiology of neuropathic pain related to IAN injuries, and describe the various surgical treatment techniques available. Between 2007 and 2013, 19 patients were referred to the Maxillofacial Surgery Department of San Paolo Hospital (Milan, Italy) with pain in the area supplied by the IAN, which developed following endodontic treatment, oral surgery and maxillofacial surgery. All patients underwent IAN surgery by several different microsurgical procedures. Most of the patients affected by pain before surgery experienced complete or partial amelioration of symptoms. All patients receiving sural nerve grafts were pain-free 12 months after surgery. In five patients the operation was unsuccessful. In 78.94% of cases, a significant increase in nerve function was observed. Pain following IAN surgical damage may be addressed by microsurgery; nerve substitution with a sural nerve interpositional graft appears to represent the most efficacious procedure. Scar releasing, nerve decompression and nerve substitution using vein grafts are less effective. Removal of endodontic material extravasated into the mandibular canal is mandatory and effective in patients experiencing severe pain. Surgery should be performed within 12 months postoperatively, ideally during the first few weeks after symptoms onset.

Original languageEnglish
Pages (from-to)1541-1545
Number of pages5
JournalJournal of Cranio-Maxillofacial Surgery
Volume43
Issue number8
DOIs
Publication statusPublished - Oct 1 2015

Fingerprint

Mandibular Nerve
Oral Surgery
Pain
Sural Nerve
Endodontics
Transplants
Therapeutics
Microsurgery
Neuralgia
Decompression
Italy
Cicatrix
Veins
Tooth
Wounds and Injuries

Keywords

  • Inferior alveolar nerve
  • Labial anesthesia
  • Labial pain

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery

Cite this

Surgical treatment of painful lesions of the inferior alveolar nerve. / Biglioli, Federico; Allevi, Fabiana; Lozza, Alessandro.

In: Journal of Cranio-Maxillofacial Surgery, Vol. 43, No. 8, 01.10.2015, p. 1541-1545.

Research output: Contribution to journalArticle

Biglioli, Federico ; Allevi, Fabiana ; Lozza, Alessandro. / Surgical treatment of painful lesions of the inferior alveolar nerve. In: Journal of Cranio-Maxillofacial Surgery. 2015 ; Vol. 43, No. 8. pp. 1541-1545.
@article{88d2067b76dd417ebee4e1f28845f9ae,
title = "Surgical treatment of painful lesions of the inferior alveolar nerve",
abstract = "Nerve-related complications are being reported with increasing frequency following oral and dental surgery, and typically involve the inferior alveolar nerve (IAN). We assess herein the etiology of neuropathic pain related to IAN injuries, and describe the various surgical treatment techniques available. Between 2007 and 2013, 19 patients were referred to the Maxillofacial Surgery Department of San Paolo Hospital (Milan, Italy) with pain in the area supplied by the IAN, which developed following endodontic treatment, oral surgery and maxillofacial surgery. All patients underwent IAN surgery by several different microsurgical procedures. Most of the patients affected by pain before surgery experienced complete or partial amelioration of symptoms. All patients receiving sural nerve grafts were pain-free 12 months after surgery. In five patients the operation was unsuccessful. In 78.94{\%} of cases, a significant increase in nerve function was observed. Pain following IAN surgical damage may be addressed by microsurgery; nerve substitution with a sural nerve interpositional graft appears to represent the most efficacious procedure. Scar releasing, nerve decompression and nerve substitution using vein grafts are less effective. Removal of endodontic material extravasated into the mandibular canal is mandatory and effective in patients experiencing severe pain. Surgery should be performed within 12 months postoperatively, ideally during the first few weeks after symptoms onset.",
keywords = "Inferior alveolar nerve, Labial anesthesia, Labial pain",
author = "Federico Biglioli and Fabiana Allevi and Alessandro Lozza",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.jcms.2015.07.036",
language = "English",
volume = "43",
pages = "1541--1545",
journal = "Journal of Maxillofacial Surgery",
issn = "1010-5182",
publisher = "Churchill Livingstone",
number = "8",

}

TY - JOUR

T1 - Surgical treatment of painful lesions of the inferior alveolar nerve

AU - Biglioli, Federico

AU - Allevi, Fabiana

AU - Lozza, Alessandro

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Nerve-related complications are being reported with increasing frequency following oral and dental surgery, and typically involve the inferior alveolar nerve (IAN). We assess herein the etiology of neuropathic pain related to IAN injuries, and describe the various surgical treatment techniques available. Between 2007 and 2013, 19 patients were referred to the Maxillofacial Surgery Department of San Paolo Hospital (Milan, Italy) with pain in the area supplied by the IAN, which developed following endodontic treatment, oral surgery and maxillofacial surgery. All patients underwent IAN surgery by several different microsurgical procedures. Most of the patients affected by pain before surgery experienced complete or partial amelioration of symptoms. All patients receiving sural nerve grafts were pain-free 12 months after surgery. In five patients the operation was unsuccessful. In 78.94% of cases, a significant increase in nerve function was observed. Pain following IAN surgical damage may be addressed by microsurgery; nerve substitution with a sural nerve interpositional graft appears to represent the most efficacious procedure. Scar releasing, nerve decompression and nerve substitution using vein grafts are less effective. Removal of endodontic material extravasated into the mandibular canal is mandatory and effective in patients experiencing severe pain. Surgery should be performed within 12 months postoperatively, ideally during the first few weeks after symptoms onset.

AB - Nerve-related complications are being reported with increasing frequency following oral and dental surgery, and typically involve the inferior alveolar nerve (IAN). We assess herein the etiology of neuropathic pain related to IAN injuries, and describe the various surgical treatment techniques available. Between 2007 and 2013, 19 patients were referred to the Maxillofacial Surgery Department of San Paolo Hospital (Milan, Italy) with pain in the area supplied by the IAN, which developed following endodontic treatment, oral surgery and maxillofacial surgery. All patients underwent IAN surgery by several different microsurgical procedures. Most of the patients affected by pain before surgery experienced complete or partial amelioration of symptoms. All patients receiving sural nerve grafts were pain-free 12 months after surgery. In five patients the operation was unsuccessful. In 78.94% of cases, a significant increase in nerve function was observed. Pain following IAN surgical damage may be addressed by microsurgery; nerve substitution with a sural nerve interpositional graft appears to represent the most efficacious procedure. Scar releasing, nerve decompression and nerve substitution using vein grafts are less effective. Removal of endodontic material extravasated into the mandibular canal is mandatory and effective in patients experiencing severe pain. Surgery should be performed within 12 months postoperatively, ideally during the first few weeks after symptoms onset.

KW - Inferior alveolar nerve

KW - Labial anesthesia

KW - Labial pain

UR - http://www.scopus.com/inward/record.url?scp=84941933875&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84941933875&partnerID=8YFLogxK

U2 - 10.1016/j.jcms.2015.07.036

DO - 10.1016/j.jcms.2015.07.036

M3 - Article

AN - SCOPUS:84941933875

VL - 43

SP - 1541

EP - 1545

JO - Journal of Maxillofacial Surgery

JF - Journal of Maxillofacial Surgery

SN - 1010-5182

IS - 8

ER -