Head and Neck Neuroma Cases

The incidence of permanent paresthesia and numbness of the face caused by iatrogenic injury to the inferior alveolar, lingual and infraorbital nerve ranges from 11,500 to 35,000 persons per year with the highest risk in ages 25–34 years. Sunderland Class IV and V injuries have a poor prognosis for spontaneous recovery and require surgical intervention, which include removal of neuroma, identification of normal nerve, and re-approximation of the nerve ends with a direct connector-assisted- repair or interpositional auto- or allograft reconstruction. This chapter will present cases of trigeminal and occipital nerve injuries and associated symptomatic neuromas. For each case, the clinical and radiographic imaging using Magnetic Resonance Neurography used to diagnose the presence of neuromas will be presented. Then, illustrations of the surgical management for the access, preparation and microsurgical repair phases will be provided.