Numb Tongue, Numb Lip, Numb Chin: What to Do When?
NUMB TONGUE, NUMB LIP, NUMB CHIN: WHAT TO DO WHEN? Ramzey Tursun, DDS, FACS Marshall Green, DDS Andre Ledoux, DMD Arshad Kaleem, DMD, MD Assistant Professor, Associate Fellowship Director of Oral, Head & Neck Oncologic and Microvascular Reconstructive Surgery, DeWitt Daughtry Family Department of Surgery, Division of Oral Maxillofacial Surgery, Leonard M. Miller School of Medicine, University of Miami INTRODUCTION MECHANISM OF NERVE Microneurosurgery of the trigeminal nerve INJURIES has been in the spotlight over the last few years. The introduction of cone-beam When attempting to classify the various scanning, three-dimensional imaging, mechanisms of nerve injury in the magnetic resonance neurography, maxillofacial region, it becomes clear that endoscopic-assisted surgery, and use of the overwhelming majority are iatrogenic allogenic nerve grafts have improved the in nature. The nerves that are most often techniques that can be used for affected in dento-alveolar procedures are assessment and treatment of patients with the branches of the mandibular division of nerve injuries. Injury to the terminal cranial nerve V, i.e., the trigeminal nerve. branches of the trigeminal nerve is a well- The lingual nerve and inferior alveolar known risk associated with a wide range of nerve are most often affected, and third dental and surgical procedures. These molar surgery is the most common cause 1 injuries often heal spontaneously without of injury. medical or surgical intervention. However, they sometimes can cause a variety of None of these nerves provide motor symptoms, including lost or altered innervation. However, damage to these sensation, pain, or a combination of these, nerves can cause a significant loss of and may have an impact on speech, sensation and/or taste in affected patients.
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