The origin of traumatic neuroma development

We read with interest the article entitled ‘Inferior alveolar nerve damage caused by bone wax in third molar surgery’ by K atre et al. . They described a case of development of traumatic neuroma causing paresthesia in the region of the inferior alveolar nerve on the basis of previous use of bone wax to control haemorrhage during third molar surgery. This case is of particular interest to our research team because we are examining the etiopathogenetic mechanism of development of traumatic neuroma. We previously proposed that traumatic neuroma development involves simultaneous nerve repair and defensive mechanisms (i.e., reactive proliferation of perineurial cells) in the region of concomitant contraction of wounds and scars on the basis of establishment of a readily violable balance between regeneration and damage of nerves . The nature of biocompatible (but not resorbable) bone wax inserted in close proximity to the inferior alveolar nerve had a similar effect and resulted in traumatic neuroma as in other cases of chronic irritation of perineurial cells in circumscribed areas. This case confirms our theory about neuroma formation. However, it should not lead to elimination of the use of bone wax from all surgical disciplines but rather should alert the surgeon not to use non-resorbable material of any kind in close proximity to nerve in circumscribed areas, especially in the very tight space of the extraction socket.

Competing interests

None declared.

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Feb 7, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on The origin of traumatic neuroma development
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