Source:Journal of Oral and Maxillofacial Surgery
Author(s): Andrew Yampolsky, Vincent Ziccardi, Sung-Kiang Chuang
PurposeDuring trigeminal nerve repair, a gap is sometimes encountered preventing the tension free apposition of nerve endings. The use of a processed acellular nerve allograft is one novel technique that shows promise in overcoming this problem. The goal of this study is to support the slowly evolving body evidence that (Avance®, Axogen, Alachua, FL.) acellular processed nerve allografts are a viable alternative to autogenous nerve grafting and the use of conduits for reconstructing defects of the trigeminal nerve.Materials and MethodsThe study design consisted of a retrospective chart review of patients referred to Rutgers School of Dental Medicine for management of trigeminal nerve injuries during a period of July 2008 to August 2014. 16 patients met the inclusion criteria of this study. All patients underwent nerve grafting using a processed nerve allograft all operations were performed by the same surgeon (VZ).Serial neurosensory testing was performed by one clinician (VZ) in a standardized fashion. The primary outcome variable was the duration of time to progress to functional sensory recovery as defined by the Medical Research Council Scale. (MRCS)ResultsParticipants age ranged from 16 to 62 with a mean age of 32. 12(75%) patients were female and 4 (25%) were male, 3 (18.75%) were smokers and 13 (81.25%) non-smokers. 8 (50%) patients underwent surgery on the inferior alveolar nerve and 8 (50%) patients underwent surgery on the lingual nerve. The most common mechanism of injury was impacted third molar removal, 9 (56.25%) 15/16 (93.75%) patients had achieved functional sensory recovery during the study period.ConclusionThe results of the present study support the hypothesis that processed nerve allograft are effective in reconstructing small (<2cm) trigeminal nerve defects.
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