IAN microsurgery – Repair of the Trigeminal Nerve
About 50-60% of patients can expect some perceived improvement in symptoms following an IAN microsurgery. Moderate to severe nerve damage are unlikely to have complete sensory recovery. Nice IAN microsurgery article.
Exactly when to refer a patient for microsurgery is debatable.
8 months to a year is when it is considered too late. “After a year, even the most expert peripheral nerve repair carries a poor prognosis. Early referral and intervention offer the best management of trigeminal nerve injuries.” Colin JADA 92 Kraut 2002 JADA
Who can one refer a patient to?
There are not many doctors that can do these cases. Dillon at UW, Miloro at UIC, Wasson and some docs in Atlanta.
Research on microsurgery
60. Microsurgical repair of IAN Bagheri SC, Meyer RA, Cho SH, et al. Microsurgical repair of the inferior alveolar nerve: success rate and factors that adversely affect outcome. J Oral Maxillofac Surg. 2012;70(8):1978-1990.
61. Meyer RA, Bagheri SC. Microsurgical reconstruction of the trigeminal nerve. Oral Maxillofac Surg Clin North Am. 2013;25(2):287-302.
62. Susarla SM, Lam NP, Donoff RB, et al. A comparison of patient satisfaction and objective assessment of neurosensory function after trigeminal nerve repair. J Oral Maxillofac Surg. 2005;63(8):1138-1144.
63. Pogrel MA. The results of microneurosurgery of the inferior alveolar and lingual nerve. J Oral Maxillofac. 2002;60(5):485-489.
64. Lam NP, Donoff RB, Kaban LB, Dodson TB. Patient satisfaction after trigeminal nerve repair. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(5):538-543.
65. Strauss ER, Ziccardi VB, Janal MN. Outcome assessment of inferior alveolar nerve microsurgery: a retrospective review. J Oral Maxillofac Surg. 2006;64(12):1767-1770.
66. Gregg JM. Studies of traumatic neuralgia in the maxillofacial region: symptom complexes and response to microsurgery. J Oral Maxillofac Surg. 1990;48(2):135-140.
Pogrel shows use autogenous vein Pogrel OMFS 2001
Related information on nerve damage
For those professionals looking for tests to confirm when to send and what to do check out my post on Dental Implant Nerve Damage.
You could also check out my post on dental nerve injury. Both posts are fairly similar in their content.