Orthognathic surgery-related nerve injuries: analysis and treatment modalities

Background: Orthognathic surgery, while highly effective in correcting dentofacial deformities, inherently poses a risk of neurosensory complications. Despite the growing volume of these surgical procedures, real-world data remain limited concerning the precise incidence, clinical course, and efficacy of various therapeutic interventions for nerve injuries in this specific context. This study aims to delineate the incidence, anatomical distribution, and treatment outcomes of trigeminal nerve injuries observed after orthognathic surgery within a tertiary care center. Methods: This retrospective cohort study involved 287 patients who underwent orthognathic surgical procedures. Data, including demographic, surgical, and follow-up course, were extracted from electronic medical records. Nerve injuries were specifically identified based on documented postoperative sensory complaints localized to the distribution of the maxillary (CN V2) or mandibular (CN V3) divisions of the trigeminal nerve. Data regarding post-operative treatment using different modalities were collected and analyzed. Results: Our retrospective review identified 17 nerve injuries based on documented postoperative sensory complaints within the CN V2 or CN V3 distributions. The various treatment modalities employed included low-level laser therapy (LLLT), corticosteroids, and vitamin B supplementation. Detailed outcomes regarding the incidence and distribution of these injuries were analyzed. Conclusions: Postorthognathic surgery trigeminal neurosensory deficits, while not common, are clinically significant. Our findings suggest that LLLT may offer a therapeutic advantage in managing these deficits, though achieving complete neurosensory recovery remains a challenge.