Contemporary Management of Mandibular Resection-Related Nerve Injury

Abstract

Trigeminal nerve sensory disturbance can result from trauma or pathology. The discomfort or pain due to sensory disturbance can be debilitating such that they cause great distress and affect the quality of life of the patients. Outcomes of nerve injury and recovery of normal function depend upon the age of the patient, the severity and type of injury, the injury time to surgical repair, the anatomy and alignment of the nerve fascicles, the method of surgical repair, and the surgical skills of the surgeon. End-to-end nerve coaptation remains the gold standard. However, in pathological conditions that require mandibular resection, the nerve is transected with a gap, and direct primary nerve repair may not be possible without putting undue tension at the site of repair. Such instances necessitate surgical repair with graft to establish continuity and function. In this chapter we will focus on surgical techniques and principles of nerve grafts for the inferior alveolar nerve.