Sensory retraining following orthognathic surgery: effect on Patient Report of the Presence of Altered Sensation

Department of Orthodontics, University of North Carolina, Chapel Hill, NC 27599, USA.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics (Impact Factor: 1.38). 12/2009; 136(6):788-94. DOI: 10.1016/j.ajodo.2008.07.015
Source: PubMed


The purpose of this analysis was to determine whether, over a 2-year period after bilateral sagittal split osteotomy, patients who received facial sensory-retraining exercises with standard opening exercises in the first 6 months after surgery were as likely to report an alteration in facial sensation as those who received standard opening exercises only.
186 subjects were enrolled in a multi-center, double-blind, stratified-block, randomized clinical trial with 2 parallel groups. Patient reports of altered sensations were obtained before surgery, and 1, 3, 6, 12, and 24 months after surgery. A marginal model was fit to examine the effect of sensory retraining while controlling for potential explanatory effects related to demographic, psychological, and clinical factors on the odds of postoperative altered sensations being reported.
Age (P <0.0001) and severity of presurgical psychological distress (P <0.0001) were significantly associated with the presence of altered sensations after controlling for the exercise training received. After controlling for age and psychological distress, patients who received opening exercises only were approximately 2.2 times more likely to report postoperative altered sensations than those who also received sensory-retraining exercises (P <0.03).
These results suggest that a simple noninvasive exercise program started shortly after orthognathic surgery can lessen the likelihood that a patient will report altered sensations in the long term after orthognathic surgery.

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    • "Early complications consist of bad splits in up to 23% of cases (Chrcanovic and Freire- Maia, 2012; Tsuji et al., 2005; Ylikontiola et al., 2002), excessive intra-operative bleeding events (Pineiro-Aguilar et al., 2011), delayed wound healing as well as failed osteosynthesis. A lip sensory deficit is known to be present in 80e100% of patients immediately after operation (Phillips et al., 2009; Wijbenga et al., 2009) and normal recovery may take up to 9 months (Jokic et al., 2012). Hypoaesthesia, up to loss of function of the inferior alveolar nerve ranging from 0 to 75%, one year after surgery can be counted as late complication (Baas et al., 2010; Parton et al., 2011; Schreuder et al., 2007) such as condylar resorption, TMJ dysfunction and relapse (Parton et al., 2011). "
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