PDF(Pubmed)
Abstract：
OBJECTIVE: To assess the impact of endoscope-assisted fractured roots or fragments extraction within the mandibular canal, along with quantitative sensory testing (QST) alterations in the inferior alveolar nerve (IAN).
METHODS: Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin.
RESULTS: The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters.
CONCLUSIONS: All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.
METHODS: Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin.
RESULTS: The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters.
CONCLUSIONS: All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.
摘要：
目的：评估内窥镜辅助下颌管内骨折根或碎片拔除的影响，以及下牙槽神经（IAN）的定量感觉测试（QST）改变。
方法：选择6例下颌第三磨牙拔除后出现下唇麻木的患者。所有患者在实时内窥镜辅助下拔除的下颌管内的根或碎片均破裂。在术后第1、7和35天进行随访评估，包括下唇皮肤的标准化QST。
结果：平均手术时间为32.5分钟，在所有情况下都暴露了IAN。其中两名患者下唇麻木完全恢复，三个经历症状改善，一名患者在手术后35天未受影响。术前QST结果显示，患侧的机械检测和疼痛阈值明显高于健康侧，但到术后第7天，五名患者明显改善，在第35天，两名患者恢复到基线。其余QST参数无显著差异。
结论：所有内镜手术均顺利完成，没有任何额外的术后并发症。没有IAN损伤恶化的病例，在大多数情况下，下唇麻木恢复。内窥镜检查允许直接观察和检查受影响的神经，促进对IAN的全面分析。
方法：选择6例下颌第三磨牙拔除后出现下唇麻木的患者。所有患者在实时内窥镜辅助下拔除的下颌管内的根或碎片均破裂。在术后第1、7和35天进行随访评估，包括下唇皮肤的标准化QST。
结果：平均手术时间为32.5分钟，在所有情况下都暴露了IAN。其中两名患者下唇麻木完全恢复，三个经历症状改善，一名患者在手术后35天未受影响。术前QST结果显示，患侧的机械检测和疼痛阈值明显高于健康侧，但到术后第7天，五名患者明显改善，在第35天，两名患者恢复到基线。其余QST参数无显著差异。
结论：所有内镜手术均顺利完成，没有任何额外的术后并发症。没有IAN损伤恶化的病例，在大多数情况下，下唇麻木恢复。内窥镜检查允许直接观察和检查受影响的神经，促进对IAN的全面分析。
