Management Of Lingual Nerve injury
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Transcript of Management Of Lingual Nerve injury
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Management Of Lingual Nerve Injury
By : Mohammed N. Omer
4th stage
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Lingual nerve:The lingual nerve is a branch of the mandibular division of the trigeminal nerve supplying the anterior two thirds of the tongue and responding to stimuli of pressure, touch, and temperature
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Nerve injury
1) Neuropraxia : refers to local myelin injury with the axon still intact and functional. considered a temporary paralysis of the nerve fiber, least severe injury
Recovery: hours to months (avg 6-8 weeks)
2) Axonotmesis : the axon and myelin is disrupted here, but the neuronal connective tissue remains intact (endo-, peri-, epineurium), more severe.
3) Neurotmesis : most severe form
not only the axon, but also injury to the myelin , axon , as well as one of the following:
a) Endoneurium
b) Perineurium
c) Epineurium, the most severe case
Recovery: incomplete; imperfect.
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Causes Of Lingual nerve injury
1. The vast majority of lingual nerve injuries occur during the extraction of a mandibular third molar .
2. less commonly the lingual nerve can be injured by local anesthetic dental injections.
3. sublingual or submandibular surgery.
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Symptoms:
1. Pain: most common symptom
2. Discomfort: discomfort when eating, chewing, talking and in performing other routine tongue functions.
3. Burning sensation. This symptom might be experienced a few days after the tooth extraction procedure.
4. Numbness tingling feeling.
5. Tugging or pulling sensation.
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Treatment
1. Surgical – a variety of procedures.
2. Laser treatment – low‐level laser treatment has been used to treat partial loss of sensation.
3. Medical – treatment with drugs including B12and painkillers.
4. Counselling – including relaxation therapy, hypnosis.
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Surgical Intervention
1. Neurorrhaphy
1. Epineural
2. Perineural
3. Epi-perineural
2. Nerve grafting
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Removal of lower 3rd molar
Division of lingual n. noted
Immediate microsurgical repair or urgent referral
Post operative review
Stimulus-evoked (paresthesia) Anesthesia (surgical intervention
maybe required)
MONITER RECOVERY
3 months after injury
Some recovery No evidence of recovery Consider referral to a specialist
Continue to monitorLimited further
recovery
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Factors that influence regeneration after neurorrhaphy
1. Age of patient
2. Gap between nerve ends
3. Delay between time of injury and repair
4. Level of injury
5. Experience & technique of surgeon
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https://www.researchgate.net/publication/8094868_Complications_associated_with_surgical_management_of_Ranulas
http://ispub.com/IJHNS/1/1/8975
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Thank You