Postoperative Patient Satisfaction and Objective Neurosensory Change After Cadaveric Nerve-Graft

Objectives: Trigeminal Nerve Injuries can be disruptive, causing intermittent or constant pain, speech difficulties, and other functional issues leading to a decrease in quality of life. The purpose of this study is to evaluate the relationship between the objective change in neurosensory status after Lingual Nerve (LN) and Inferior Alveolar Nerve (IAN) repair with a cadaveric nerve allograft (Avance Nerve Graft AxoGen, Inc., Alachua, Fl.) and the resultant patient satisfaction.
Methods: A retrospective analysis of subjective neurosensory function of 18 subjects with 20 procedures who underwent LN and IAN nerve grafting was completed. Neurosensory testing at the preoperative visit and at the 6-month post-operative visit was collected, along with demographic and surgical data. Statistical significance was established through t-tests. Subjects completed an anonymous Oral Health Impact Profile (OHIP) questionnaire for postoperative patient satisfaction.
Results: The mean duration between injury and repair for LN was 5.45 months and for IAN was 13.57 months. The majority of patients (90%) with LN damage regained sensation or taste with 45% regained only sensation, 27% partial taste, and 18% full taste. IAN damage in 67% of patients and 56% in LN patients described their postoperative satisfaction as good to excellent. Postoperative satisfaction was significantly improved from their preoperative condition with p-values of 0.003 (LN) and 0.005 (IAN). There is a significant positive correlation between improved patient satisfaction and improved neurogenic numbness (rho=0.82; P<0.0001). There is a significant positive correlation between decreased neuropathic pain and improved quality life (rho=0.92; P<.01).
Conclusions: These data suggest that patients suffering from injury to the IAN or LN may benefit from surgical repair with allograft (Avance’s cadaveric nerve graft) and show improvement from neuropathic pain and anesthesia. The majority of patients reported improved satisfaction and improved oral function.