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Background <p>Inferior alveolar nerve (IAN) injury is the most frequent complication following bilateral sagittal split ramus osteotomy (BSSRO), often resulting in neurosensory disturbance that impacts quality of life. Early postoperative recovery patterns remain relatively underreported despite their clinical relevance.</p> Purpose <p>To evaluate early neurosensory recovery of the IAN following BSSRO using a modified assessment approach focusing on mechanoreceptive modalities and a culturally adapted, non-validated questionnaire.</p> Study Design, Setting, Sample <p>This pilot prospective cohort study included 10 patients undergoing BSSRO at a tertiary care centre.</p> Predictor Variable <p> Time since surgery (1, 4, 8, 12 weeks, 6 months, and 12 months postoperatively).</p> Main Outcome Variables <p>Objective recovery assessed by static light touch (SLT), brush directional stroke (BDS), and two-point discrimination (TPD). The secondary outcome was subjective recovery assessed using a modified 15-item questionnaire grouped into sensory, functional, and psychological domains.</p> Covariates <p>Demographic factors (age, sex), diagnosis (prognathism or retrognathism), and magnitude of mandibular movement.</p> Analyses <p>Repeated-measures ANOVA assessed changes across time points; chi-square tests analyzed nominal variables. Significance was set at <i>P</i> &lt; 0.05.</p> Results <p>All patients had IAN disturbance at week 1. SLT scores improved significantly, with 60% achieving full recovery at 12 weeks (left: <i>P</i> = 0.042; right: <i>P</i> = 0.046). BDS recognition increased from 10% at week 1 to 70% at week 12 (<i>P</i> = 0.038). TPD thresholds improved from 90% “poor” at week 1 to 70% “normal” at week 12 (<i>P</i> = 0.001). Subjective sensory and functional scores improved significantly (sensory: 3.45 ± 0.48 to 2.50 ± 0.53; functional: 3.40 ± 0.55 to 2.33 ± 0.52; both <i>P</i> &lt; 0.05), while psychological scores remained stable (<i>P</i> &gt; 0.05).</p> Conclusions and Relevance <p>The 4–12 week interval represents a clinically meaningful early neurosensory recovery window following BSSRO. This modified assessment approach appears clinically feasible for early evaluation; however, as a pilot cohort, findings require validation in larger studies.</p> Trial Registration <p>Registered with the Clinical Trials Registry – India (CTRI): CTRI/2024/08/072364.</p>

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Early Neurosensory Evaluation of Inferior Alveolar Nerve Following Bilateral Sagittal Split Osteotomy: A Pilot Prospective Cohort Study Using a Modified Assessment Approach

  • 期刊论文

  • 发表日期：

    2026年5月23日

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  • Vipul Jain,
  • Prajesh Dubey,
  • Apoorva Mowar,
  • Sameer Pandey,
  • Priyanka Shanker,
  • Athira Balagopal

摘要

Background

Inferior alveolar nerve (IAN) injury is the most frequent complication following bilateral sagittal split ramus osteotomy (BSSRO), often resulting in neurosensory disturbance that impacts quality of life. Early postoperative recovery patterns remain relatively underreported despite their clinical relevance.

Purpose

To evaluate early neurosensory recovery of the IAN following BSSRO using a modified assessment approach focusing on mechanoreceptive modalities and a culturally adapted, non-validated questionnaire.

Study Design, Setting, Sample

This pilot prospective cohort study included 10 patients undergoing BSSRO at a tertiary care centre.

Predictor Variable

Time since surgery (1, 4, 8, 12 weeks, 6 months, and 12 months postoperatively).

Main Outcome Variables

Objective recovery assessed by static light touch (SLT), brush directional stroke (BDS), and two-point discrimination (TPD). The secondary outcome was subjective recovery assessed using a modified 15-item questionnaire grouped into sensory, functional, and psychological domains.

Covariates

Demographic factors (age, sex), diagnosis (prognathism or retrognathism), and magnitude of mandibular movement.

Analyses

Repeated-measures ANOVA assessed changes across time points; chi-square tests analyzed nominal variables. Significance was set at P < 0.05.

Results

All patients had IAN disturbance at week 1. SLT scores improved significantly, with 60% achieving full recovery at 12 weeks (left: P = 0.042; right: P = 0.046). BDS recognition increased from 10% at week 1 to 70% at week 12 (P = 0.038). TPD thresholds improved from 90% “poor” at week 1 to 70% “normal” at week 12 (P = 0.001). Subjective sensory and functional scores improved significantly (sensory: 3.45 ± 0.48 to 2.50 ± 0.53; functional: 3.40 ± 0.55 to 2.33 ± 0.52; both P < 0.05), while psychological scores remained stable (P > 0.05).

Conclusions and Relevance

The 4–12 week interval represents a clinically meaningful early neurosensory recovery window following BSSRO. This modified assessment approach appears clinically feasible for early evaluation; however, as a pilot cohort, findings require validation in larger studies.

Trial Registration

Registered with the Clinical Trials Registry – India (CTRI): CTRI/2024/08/072364.