Trigeminal sensory recovery using processed nerve allografts for large continuity defects

The processed nerve allograft, Avance (AxoGen, Alachua, FL), has become a popular alternative to an autograft for the repair of nerve injuries, including the trigeminal nerve. Clinical outcome data on their safety and effectiveness in restoring sensory function of the trigeminal nerve is needed. Sensory assessments of trigeminal nerve injuries were conducted at pre-surgical, 3, 6, and 12 months post-surgical reconstruction with Avance® Nerve Graft. Subjects with at least 6 months of follow-up were included in this analysis. Assessments included brush stroke directional sensation (BSDS), static 2-point discrimination (s2PD), contact detection (CD), pressure pain threshold, and pressure pain tolerance. Adverse events were assessed. The study consisted of 18 subjects with 20 trigeminal nerve reconstructions, 2 subjects had 2 reconstructions. All injuries were reconstructed with processed nerve allograft. Fourteen subjects with 16 reconstructions had sufficient follow-up data for outcomes analysis. The subjects were 7 males and 7 females with 12 lingual nerve and 4 inferior alveolar nerve reconstructions. The mean age was 31 + 15 (9, 67) years old and the mean time between injury and surgery was 217 + 199 (0, 527) days. Twelve of the 16 reconstructions reported the gap length of injury, giving an average of 30 + 24 (15, 70) mm. Improvements in sensory function were reported in 14 out of the 16 reconstructions with processed nerve allograft (87%). Six repairs reported within normative limits at level A with a gap range of 15-70 mm. Seven repairs were within normative limits at level B and 13 repairs were within normative limits at level C. There were no repairs reporting complete sensory impairment. There were no adverse events recorded. Processed nerve allografts were found to be safe and effective in Trigeminal sensory nerve defects between 15 and 70 mm in either immediate or delayed nerve reconstruction

Only gold members can continue reading. Log In or Register to continue

Jan 20, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Trigeminal sensory recovery using processed nerve allografts for large continuity defects
Premium Wordpress Themes by UFO Themes