International Journal of Oral and Maxillofacial Surgery
Clinical PaperOral SurgeryEvaluation of trigeminal nerve injuries in relation to third molar surgery in a prospective patient cohort. Recommendations for prevention
Section snippets
Methods
The records of 254 patients with trigeminal nerve injuries collected over 3 years, were consulted at the Dental Institute in King's College Hospital, London. Within this cohort, 38 patients presented with trigeminal neuropathy caused by neurological disease, malignancy, multiple sclerosis, sickle cell disease, known alcoholism, injury caused by non-dental trauma, orthognathic surgery, diabetes, HIV, post-herpetic neuralgia, stroke and patients taking chemotherapy. This study evaluated the
Results
This study evaluates 120 patients who presented with trigeminal nerve injury related to TMS, of whom 67 (55.8%) presented with LNI and 53 (44.2%) with IANI. The majority of these injuries were caused by TMS carried out under local anaesthesia (LA, 34 IANI cases and 36 LNI cases), followed by TMS under general anaesthesia (GA, 9 IANI cases and 22 LNI cases). In one case, IANI was caused when a lower 7 was removed in addition to TMS. Significantly more females had IANI and LNI (p < 0.05) and the
Discussion
The removal of wisdom teeth is amongst the most frequently practiced procedures by dentists world wide. In the UK, approximately 300,000 patients undergo M3M removal every year in the national health service, mainly under LA. A large proportion of this patient group presenting with nerve injuries had surgery under GA. Significantly larger neuropathic areas (80%) resulted from TMS carried out under GA in comparison to TMS carried out under LA. This may reflect the increased difficulty of the
Funding
None.
Competing interests
None declared.
Ethical approval
Not required.
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