J Korean Assoc Oral Maxillofac Surg.  2011 Oct;37(5):355-364.

Recovery of lingual nerve injury: retrospective observational study

• Hong DH
• Lim HK
• Kim SM
• Kim MJ
• Lee JH

Abstract

INTRODUCTION
This study evaluated nerve recovery through retrospective study of patients with lingual nerve damage.
PATIENTS AND METHODS
The patients who visited Seoul National University Dental Hospital for an injury to the lingual nerve from April 1988 to August 2009 were enrolled in this study (n=41). The relevance of various factors including the causes of damage, age, etc. was analyzed by the subjective improvement based upon questionnaires and the clinical records. The evaluation variants were a subjective assessment and neurosensory examination composed of the direction, contact threshold, two-point discrimination, pin prick, thermal discrimination and current perception threshold.
RESULTS
The causes of lingual nerve damage were an extraction of the lower third molar (75.6%), local anesthesia (9.7%), incision and drainage (4.88%), trauma (2.44%). The evaluation of subjective prognosis exhibited no difference in sensory improvement depending on the cause, age and gender. Based upon the subjective evaluation, 44.7% of patients showed sensory improvement. The first hospital visit from injury was shorter in the group showing subjective improvement (3.41 months) than those showing no improvement (5.24 months) (P=0.301). Thirty six out of 41 patients were treated with only conservative therapy and 5 patients were treated by surgical intervention. Neurosensory examinations revealed improvement, although not statistically significant, and the degree was higher in the subjectively improved group. The contact threshold discrimination showed the highest correlation with subjective improvement (P=0.069). Most of the sensory recovery was gained within 12 months and the degree of improvement at the tip of the tongue was higher than that of the dorsum (P<0.001).
CONCLUSION
The damaged lingual nerve improved at a rate of 44.7% and mostly within 12 months after the incident. There was no difference between the subjective prognosis and neurosensory examination depending on the cause of damage, age and gender, whereas the contact threshold discrimination was the best variant that reflected the subjective prognosis statistically.

Keyword

Lingual nerve; Nerve injury; Retrospective study

MeSH Terms

Anesthesia, Local
Discrimination (Psychology)
Drainage
Humans
Lingual Nerve
Molar, Third
Prognosis
Surveys and Questionnaires
Retrospective Studies
Tongue

Figure

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  Fig. 1. The degree of improvement of paresthesia and relief of pain just after lingual nerve injury based upon questionnaire (Recovery index). Contact, Contact threshold; Pain, Pain perception; Thermal, Thermal threshold Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 2. Comparison of average and standard deviation of each neurosensory examination (value1 and normalized result2) between initial and final visit in group treated by preservative treatment only. DD, Direction discrimination; 2PD, 2-point discrimination; CT, Contact threshold; PP, Pain perception; TT, Thermal threshold value1, measured result; normalized result2, ratio of measured result to that of normal side Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 3. The ratio of improved, unchanged and aggravated patients to all patients at neurosensory test in group treated by preservative treatment only. DD, Direction discrimination; 2PD, 2-point discrimination; CT, Contact threshold; PP, Pain perception; TT, Thermal threshold. Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 4. Comparison of average and standard deviation of each neurosensory examination (value1 and normalized result2) between initial and final visit in group which were treated by preservative treatment only and showed subjective improvement. DD, Direction discrimination; 2PD, 2-point discrimination; CT, Contact threshold; PP, Pain perception; TT, Thermal threshold. value1, measured result; normalized result2, ratio of measured result to that of normal side. Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 5. The change over time of perception threshold of two groups. Recovery, received preservative treatment and improved subjectively; Non-recovery, received preservative treatment but not improved. Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 6. The change over time of results of neurosensory examinations at subjectively improved patients (n=8). Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 7. Comparison of average and standard deviation of each neurosensory examination(value1 and normalized result2) between initial and final visit in group which were treated by surgical treatment. DD, Direction discrimination; 2PD, 2-point discrimination; CT, Contact threshold; PP, Pain perception; TT, Thermal threshold. value1, measured result; normalized result2, ratio of measured result to that of normal side. Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 8. The ratio of improved, unchanged and aggravated patients to all patients at neurosensory test in group treated by surgical treatment. DD, Direction discrimination; 2PD, 2-point discrimination; CT, Contact threshold; PP, Pain perception; TT, Thermal threshold. Dong-Hwan Hong et al: Recovery of lingual nerve injury: retrospective observational study. J Korean Assoc Oral Maxillofac Surg 2011

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