| 1. |
- Al-Bishri, A, et al.
(författare)
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Incidence of neurosensory disturbance after sagittal split osteotomy alone or combined with genioplasty
- 2004
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Ingår i: The British journal of oral & maxillofacial surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 42:2, s. 105-11
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Tidskriftsartikel (refereegranskat)abstract
- We mailed questionnaires to all patients who had had sagittal split osteotomies alone (n=84) or in combination with genioplasty (n=37) between 1995 and 2000, to find out the incidence of postoperative sensory disturbances. The patients with sagittal split osteotomies alone reported sensory disturbance in 48/131 (37%) operated sides. When combined with genioplasty patients experienced them in 20/54 (37%) operated sides. The incidences were 36/101 (36%) for mandibular advancement and 12/30 (40%) for mandibular setback. Out of the patients with sagittal split osteotomies alone, 59/66 (89%) were satisfied with the result of the operation, and when combined with the genioplasty the corresponding figure was 23/27 (85%). We conclude that differences in the incidence of sensory disturbance after sagittal split osteotomy for mandibular advancement and setback were not significant. The combination with genioplasty did not increase the incidence of sensory disturbance. Sensory changes after the osteotomies do not serve to be the main determinant of the patients’ satisfaction.
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| 2. |
- Al-Bishri, Awwad, et al.
(författare)
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Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy : as reported in questionnaires and patients' records
- 2005
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027 .- 1399-0020. ; 34:3, s. 247-251
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This retrospective study aimed at evaluating the long-term incidence of neurosensory disturbance (NSD) after sagittal split osteotomy (SSO) and intraoral vertical ramus osteotomy (IVRO). Furthermore, a comparison was made between the results obtained by questionnaires and information in the patient records in the evaluation of nerve function. Finally, the degree of discomfort caused by the NSD was evaluated. One hundred and twentynine patients, who underwent IVRO (79 patients) and SSO (50 patients), were included. Questionnaires were mailed to the patients at least one year after the operation. The records of all patients, who returned the questionnaires, were reviewed. The results of NSD obtained by questionnaires and records differed indicating a disagreement between the judgement of the surgeon and the patient's opinion. Long lasting NSD was underestimated by the surgeon as compared to the patient's subjective symptom. Long lasting NSD was reported in 7.5% (questionnaire), 3.8% (record) after IVRO and in 11.6% (questionnaire) and 8.1% (record) after SSO.
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| 3. |
- Barghash, Ziad, 1973, et al.
(författare)
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Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves
- 2013
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027. ; 42:12, s. 1566-1574
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod for 30 s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both in the normal anatomy and in the regenerative pattern. The mental nerve had a larger cross-sectional area including all tissue components. The mental nerve had a larger volume fraction of myelinated axons and a correspondingly smaller volume fraction of endoneurium. No differences were observed in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than it is in the mental nerve (somatosensory function).
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| 4. |
- Barghash, Ziad, 1973
(författare)
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On nerve function after Orthognatic Surgery
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Orthognathic surgery is a surgical intervention to correct dentofacial anomalies. It is a complicated treatment that involves cooperation of different specialties. The success of orthognathic surgery is multifactorial with many elements to be taken into consideration. It is estimated that about 11 patients among every 100.000 Swedish citizens are in need of orthognathic surgeries. The most common surgical procedures for correction of mandibular deformities are the sagittal split osteotomy (SSO) and vertical ramus osteotomy (VRO), which is done either with an intraoral approach (IVRO) or an Extraoral approach (EVRO). Genioplasty is also often done, sometimes combined with other orthognathic surgeries. Despite the various modifications added to these operations to enhance their performance and results, nerve injury afterwards, especially after the SSO can occur. Neurosensory disturbance (NSD) following such trauma is still the main and most common drawback after these operations. Objectives This thesis is based on five studies. The aims of the first study were to investigate the incidence of sensory changes after SSO and whether it was different between osteotomy alone and osteotomy with genioplasty and to assess the impact of sensory disturbances on patients’ satisfaction. The second study aims were to evaluate NSD after SSO and IVRO, asses the difference between questionnaire and patient’s record in evaluating the NSD and to evaluate the discomfort caused by NSD. The aim of the third study was to assess the patients’ satisfaction after EVRO and discomfort regarding sensory and motor nerve disturbances. The fourth and fifth study aimed to investigate in an experimental animal model the difference in degenerative and regenerative patterns between a sensory and a motor nerve (the Mental Nerve (MN) and the Buccal branch of Facial Nerve (BF) respectively) using an unbiased stereological technique and further to study the effect of Steroids on nerve de- and regeneration. Material and Method For the first 3 retrospective studies, questionnaires were sent to the patients. In addition, answers in the second study were checked against patients' records. Paper 4 and 5 were animal studies; MN and the BF were injured in 48 Wister rats, half of which were treated with steroids perioperatively. The injured nerves were then studied using an unbiased technique called 2D Stereology. Results No significant differences in NSD incidence were found between the patients who had osteotomy alone and those who also had genioplasty. Sensory disturbances are not a main determinant of patients’ satisfaction. There was disagreement between patients' records and questionnaire in which symptoms of long lasting NSD were underestimated by the surgeon. Only 1% had permanent NSD following EVRO although resultant scar tissue was of concern to 30% of patients involved. The regenerative process is faster and/or more complete in the facial nerve (motor function) than it is in the mental nerve (sensory function). There were an increased number of regenerating axons after perioperative treatment with Betamethasone in both facial and mental nerves indicating that Betamethasone enhanced nerve regeneration in both motor and sensory nerves.
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