A prospective, quantitative study on the clinical outcome of inferior alveolar nerve decompression and neurolysis

Aim: The management of persistent anaesthesia or dysaesthesia following damage to the inferior alveolar nerve is difficult, and the benefit of interventions is often unclear. We have evaluated the outcome of inferior alveolar nerve decompression and neurolysis in a series of 25 patients, with injuries usually sustained during third molar removal, who had poor spontaneous recovery. Materials and methods: The mean age at surgery was 45 years, and most patients were female (21 patients). The mean period between the initial injury and decompression was 28 months, and we assessed the final outcome at 1 year or more after decompression. Assessment included the responses to a series of standard questions, completion of visual analogue scales (VAS) and sensory tests. Results: We found that after decompression fewer patients reported pain, and VAS scores were significantly reduced for the level of tingling. Patients also reported better subjective levels of sensation after decompression, and sensory tests confirmed small but significant improvements. The median subjective value of the operation was assessed by patients as 7 (range 0-10). Conclusions: These data show that inferior alveolar nerve decompression results in significant reductions in the level of dysaesthesia and improvements in sensation. However, as the overall level of improvement is small, and some patients do not improve, the procedure should only be offered to patients who are significantly affected by their symptoms. © 2008 The Authors Journal compilation © 2008 Blackwell Munksgaard.