Our Summary

This research paper studies the lingual nerve (LN), which can sometimes be injured during oral surgery, especially when removing the third molar or “wisdom tooth”. By looking at many studies of the LN’s structure, the researchers hoped to help reduce the risk of harming this nerve during surgery.

The researchers looked at online databases such as PubMed and Web of Science to find relevant studies. The results are based on information from 1665 lingual nerves. They found that in about 78% of cases, the LN is found below a certain point in the mouth (the “lingual/alveolar crest”). In about 8% of cases, the nerve is located above this point.

They also found that the LN can have different shapes - it was round in about 41% of cases, oval in about 38% of cases, and flat in about 25% of cases. Additionally, the LN was found to enter the tongue under a certain duct in the mouth in about 68% of cases.

This research is considered to be very accurate and up-to-date. It’s crucial for surgeons to know about the LN’s anatomy to prevent nerve damage during oral and maxillofacial surgery, especially when removing wisdom teeth.

FAQs

  1. How can the lingual nerve be injured during oral surgery?
  2. What are the typical positions and shapes of the lingual nerve according to the research?
  3. Why is it crucial for surgeons to understand the anatomy of the lingual nerve?

Doctor’s Tip

One helpful tip a doctor might tell a patient about oral surgery is to make sure to follow all pre-operative and post-operative instructions provided by the surgeon. This can help reduce the risk of complications and promote faster healing. Additionally, it’s important to inform the surgeon about any medical conditions or medications the patient is taking, as this information can impact the surgery and recovery process.

Suitable For

Patients who may be recommended for oral surgery include those who need to have their wisdom teeth removed, have impacted teeth, have jaw alignment issues, require dental implants, need to have a biopsy performed, have facial or jaw injuries, have sleep apnea, or have oral infections or cysts. Additionally, patients with certain medical conditions such as cancer, diabetes, or autoimmune disorders may also be recommended for oral surgery. It is important for patients to consult with their oral surgeon to determine if oral surgery is the best treatment option for their specific condition.

Timeline

Before oral surgery:

  1. Patient consults with oral surgeon to discuss treatment options and risks.
  2. Patient undergoes pre-operative evaluation and possibly imaging studies.
  3. Patient receives instructions on pre-operative care, such as fasting before surgery.
  4. On the day of surgery, patient arrives at the surgical facility and receives anesthesia.

During oral surgery:

  1. Surgeon performs the procedure, such as removing a wisdom tooth or performing a dental implant.
  2. Patient is monitored closely by the surgical team.
  3. After the procedure is completed, patient is moved to a recovery area.

After oral surgery:

  1. Patient may experience pain, swelling, and bleeding at the surgical site.
  2. Patient is prescribed pain medication and given instructions on post-operative care, such as rest and ice packs.
  3. Follow-up appointments may be scheduled to monitor healing and remove sutures.
  4. Patient gradually resumes normal activities and diet as instructed by the surgeon.
  5. Lingual nerve function is monitored to ensure there is no damage or complications.

Overall, the timeline of a patient’s experience before and after oral surgery involves thorough preparation, careful monitoring during the procedure, and attentive post-operative care to ensure a successful outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about oral surgery, specifically regarding the risk of lingual nerve injury, include:

  1. What steps will be taken to minimize the risk of lingual nerve injury during my oral surgery procedure?
  2. What is the likelihood of experiencing lingual nerve damage during this specific type of oral surgery?
  3. What are the potential symptoms of lingual nerve injury that I should be aware of post-surgery?
  4. How long does it typically take for lingual nerve injuries to heal, and what are the potential long-term effects?
  5. Are there any specific factors about my anatomy or medical history that may increase my risk of lingual nerve injury during oral surgery?
  6. What are the alternative treatment options available if lingual nerve injury occurs during the procedure?
  7. Can you provide me with information about the experience and success rate of your practice in preventing lingual nerve injuries during oral surgery?
  8. Are there any specific post-operative care instructions I should follow to minimize the risk of lingual nerve injury during the healing process?
  9. What are the signs that I should look out for that may indicate lingual nerve injury following oral surgery?
  10. Can you explain the potential complications and risks associated with lingual nerve injury in more detail?

Reference

Authors: Ostrowski P, Bonczar M, Wilk J, Michalczak M, Czaja J, Niziolek M, Sienkiewicz J, Szczepanek E, Chmielewski P, Iskra T, Gregorczyk-Maga I, Walocha J, Koziej M. Journal: Clin Anat. 2023 Sep;36(6):905-914. doi: 10.1002/ca.24033. Epub 2023 Mar 9. PMID: 36864652