Sensory Retraining Exercise Facilitates Sensory Recovery after Bilateral Sagittal Split Osteotomy---A Prospective, Randomized Controlled Trial

Background and purpose: The bilateral sagittal split osteotomy(BSSO) is one of the most common surgical procedure to correct mandibular skeletal problem. However, the incidence of inferior alveolar nerve injury in this procedure after operation one month is nearly 70%~80％ and until one year follow up, there is about 10％ patients have altered sensory. The clinical symptoms are numbness or paraesthestia over the patients’ lower lip. Most of them will spontaneous sensory recovery at the sixth month and some of them will wait for one year or permant with altered sensation. However, there is not any therapy to help them accelerate sensory recovery and improve the altered sensation after BSSO so far in our hospital. Therefore, we want to establish a standard and effective sensory retraining exercise to facilitate sensory recovery. Design of the study: The study is a prospective randomized controlled trial. The patients receiving bilateral sagittal split osteotomy and having lip numbness or paraesthesia will be included in this study. 120 patients will be included and first and divided into two groups according their age (18-29 years old and 30-40 years old, each group 60 patients). Then the each group(60 patients) will be randomized enrolled into two groups and there are 30 patients in each group. The control group is to maintain follow up in clinic and do not receive any sensory retraining exercise. The experimental group is requested to perform sensory retraining at home by themselves. The normal group includes the 30 patients of normal sensation after the surgery. We do sensory function test at one week before surgery, one week, one, two, three, four, five, six months and one year after surgery. The sensory function evaluation include objective and subjective examinations as the followings: 1. Questionnaire 2. Visual analogue scale (VAS) 3. Two-point discrimination (2PD) 4. Pain detection threshold (PD) tests 5. Touch sensory threshold Statistic method: 1. Use independent-sample T test to compare two groups difference 2. Use Generalized estimating equation(GEE) to analysis the difference at one week before surgery, one week, one, two, three, four, five, six months and one year after surgery. Anticipated results： At present, there is no standardized sensory retraining program established to help sensory disturbance in the patients receiving bilateral sagittal split osteotomy. A prospective, randomized controlled trial will be carried out to provide clinical evidence to support the effective sensory retraining program for mandibular nerve sensory recovery.

Project ID:PC10107-0373
External Project ID:NSC101-2314-B182-050