Abstract
Post operative nerve injury following mandibular third molar (M3M) potentially impacts
a significant number of patients. A lack of consensus for the management of trigeminal
nerve injuries exists. It is important to know how clinicians manage these injuries,
and how confidently. A 16-question online survey using SurveyMonkey was developed
and sent to all current UK members of three oral srelated societies (ABAOMS, BAOS
and BAOMS) from January 2021 to March 2021. The survey consisted of open free text,
binomial and variable scale responses related to the management of inferior alveolar
nerve and lingual nerve injuries. A total of 158 clinicians responded to the survey.
The average number of M3M removed monthly over the last three years by a clinician
was 25. The average number of nerve injuries seen in a clinician’s practice, within
the last three years, was three. Over two-thirds of respondents were only somewhat
confident, not so confident, or not at all confident in the management of patients
with inferior alveolar nerve (IAN) and lingual nerve (LN) injury. In occurrence of
an injury, only 45% stated they would make an onward referral and a minority of clinicians
had access to surgical repair within their own unit. Free text responses highlighted
themes of a lack of UK awareness of management interventions and pathways for these
patients. Clear national guidance on managing trigeminal nerve injuries was a commonly
desired theme from responding clinicians. Joint speciality partnerships and a national
nerve repair registry is now required.
Keywords
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References
McArdle LW, Renton T. The effects of NICE guidelines on the management of third molar teeth. British Dental Journal. 2012;213(5):E8-E.
- Current perspectives on the surgical management of mandibular third molars in the United Kingdom: the need for further research.British Journal of Oral and Maxillofacial Surgery. 2020; 58: 348-354
- Sensory impairment of the lingual and inferior alveolar nerves following removal of impacted mandibular third molars.International Journal of Oral and Maxillofacial Surgery. 2001; 30: 306-312
- Quality of life following injury to the inferior dental or lingual nerve – a cross-sectional mixed-methods study.Oral Surgery. 2018; 11: 9-16
- Efficacy of Acellular Nerve Allografts in Trigeminal Nerve Reconstruction.J Oral Maxillofac Surg. 2017; 75: 2230-2234
- Interventions for iatrogenic inferior alveolar and lingual nerve injury.Cochrane Database of Systematic Reviews. 2014; 4
- Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review.J Oral Rehabil. 2015; 42: 786-802
- Does early repair of trigeminal nerve injuries influence neurosensory recovery? A systematic review and meta-analysis.International Journal of Oral and Maxillofacial Surgery. 2020;
- Magnetic Resonance Neurography of Traumatic and Nontraumatic Peripheral Trigeminal Neuropathies.Journal of Oral and Maxillofacial Surgery. 2018; 76: 725-736
- Retrospective review of microsurgical repair of 222 lingual nerve injuries.J Oral Maxillofac Surg. 2010; 68: 715-723
- When to refer a patient with a nerve injury to a specialist.The Journal of the American Dental Association. 2014; 145: 859-861
- Clinical outcomes of lingual nerve repair.British Journal of Oral and Maxillofacial Surgery. 2021; 59: 39-45
- Trend towards centralisation of hospital services, and its effect on access to care for rural and remote communities in the UK.Rural Remote Health. 2005; 5: 390
- Economic evaluations on centralisation of specialised healthcare services: a systematic review of methods.BMJ Open. 2016; 6e011214
- How to provide specialist services: how do we know when centralisation is a good idea?.Postgraduate Medical Journal. 2021; 97: 69-71
- The benefit of surgical management in post-traumatic trigeminal neuropathy: a retrospective analysis.International Journal of Oral and Maxillofacial Surgery. 2021; 50: 132-138
- Microsurgical Repair of the Inferior Alveolar Nerve: Success Rate and Factors That Adversely Affect Outcome.Journal of Oral and Maxillofacial Surgery. 2012; 70: 1978-1990
- Current management of damage to the inferior alveolar and lingual nerves as a result of removal of third molars.British Journal of Oral and Maxillofacial Surgery. 2004; 42: 285-292
- Diagnosis, pathophysiology, management and future issues of trigeminal surgical nerve injuries.Oral Surgery. 2020; 13: 389-403
- Advances in microsurgical nerve repair.Journal of Oral and Maxillofacial Surgery. 1993; 51: 62-68
Lawler M, Turnbull C. DATA-CAN The Health Data Research Hub for Cancer. New data on the impact of COVID-19 on head and neck cancers. [Available from: https://www.data-can.org.uk/news-item/new-data-on-the-impact-of-covid-19-on-head-and-neck-cancers/ Accessed June 2021]
Article Info
Publication History
Published online: February 02, 2022
Accepted:
January 26,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
