하치조신경전위술을 병행한 구강악안면외과영역의 수술

REPOSITIONING OF THE INFERIOR ALVEOLAR NERVE IN OROMAXILLOFACIAL SURGERY

The inferior alveolar or mental nerves may be damaged during several routine surgical procedures on the madible These include removal of wisdom teeth, various grafting for mandibular augmentation and implantation procedures, etc. Therefore, intentional reposition of the inferior alveolar nerve doesn t only facilitate various surgery but also minimizes damage to infeior alveolar nerve which has been indicated as adjunctive techniques for orthognathic surgery, vestibuloplasty, and implantation of atrophied posterior mandible. We have done that repositioning of the inferior alveolar nerve for mandibular body osteotomy, rigid internal fixation ot fractured mandible, en bloc resection of ameloblastoma, enucleation of radicu-lar cyst, and implantation of the atrophied posterior mandible. So, it was possible for us to facilitate RIF for immediate repair of the continuity defect near the mental foramen without retraction of mental nerve We could lessen the risk of iatrogenic nerve damage and complete removal of lesion during the enucleation of intrabony lesion approximated neurovascular bundle. The effect of vertical height augmentation of mandible tor implant has made superior functional restorative rehabilitation during the implantation of atrophied posterior mandible. Neurosensory evaluation was performed using the two-point discrimination test. All patients have immediated neurosensory alteration associated with the neurovascular bundle manipulations. 5 Patients with unilateral reposition had good recovery and returned to normal neurosensory function in 12 to 21 months postoperatively. As for the case of one patient with bilateral reposition only 4 months of followup period has passed. So the result remains to be seen. The approach mentioned above has got a good result in minimzing the long-term neurosensory disturbances and facilitating various mandibular surgery. This paper, therfore, reports on the literature on the matter.