management of the nerve-injured patient are reflected inthe AAOMS Parameters and Pathways. Specific surgicaltechniques depend upon which nerve is involved, aswell as the extent of injury. Microneurosurgical repairinvolves neurolysis and preparation of the nerve stumpsin order to perform neurorrhaphy. Several studies doc-ument the deleterious effects of tension on a nerverepair site, so an inability to perform primary repair withsutures warrants the consideration for an autogenousnerve graft, or other option for management of the nervegap (entubulation). Following surgery, postoperativesensory reeducation may augment the repair process.
The field of microneurosurgery continues to evolve.As more surgeons become familiar with the diagnosisand management of nerve-injured patients, and as morelaboratory and clinical research information becomesavailable, we will be better able to guide therapy forthese difficult problems. Also, residency programs willbe able to teach the principles and practice of microneu-rosurgery to surgeons in training, and foster access tocare throughout the country, or at least in regional cen-ters of excellence.
This surgical clinic is designed to provide the requisiteinformation necessary for the practicing Oral and Max-illofacial Surgeon, as well as the resident in training,regarding the diagnosis and management, and referral, ofthe patient with a trigeminal nerve injury.
References
Zuniga JR, Meyer RA, Gregg JM, Miloro M. The accuracy of clinicalneurosensory testing, for nerve injury diagnosis. J Oral Maxillofac Surg56: 2-8, 1998
Robinson PP, Loescher AR, Yates JM, Smith KG. Current manage-ment of damage to the inferior alveolar and lingual nerves as a result ofremoval of third molars. Br J Oral Maxillofac Surg 42: 285-92, 2004
Ziccardi V. Timing of trigeminal nerve microsurgery: A review of theliterature. J Oral Maxillofac Sug 65: 1341, 2007
L523Volunteering for Surgical MissionsAbroadDavid C. Hoffman, DDS, Staten Island, NY
No abstract provided.
Lunch and Learn Sessions
144 AAOMS • 2009
