Application of magnetic resonance neurography in early diagnosis and therapy in a case of lingual nerve injury

doi:10.3877/cma.j.issn.1674-1366.2023.06.007

Abstract

Abstract:

Lingual nerve injury is one of the serious complications in alveolar surgery, which often occurs after the extraction of the mandibular third molar (M3M), with the incidence varying from 0.1% to 22%.Due to the limitations of clinical and conventional radiographical examinations, some severe cases do not receive accurate diagnosis and effective treatment in the early stage of injury, resulting in permanent lingual nerve injury and consequent impact on the quality of life. In recent years, magnetic resonance neurography (MRN) has been gradually used in the examination of nerve injury, and several new MRN sequences have reasonable visualization of severe lingual nerve injury, making early diagnosis and therapy possible. This article reported a patient with lingual nerve injury caused by the removal of M3M for 2 weeks, and complete disconnection of the affected lingual nerve was clearly visualized through MRN. Subsequently, a nerve anastomosis surgery was performed, and the disconnection was observed during the operation, proving the consistency of the MRN imaging and the fact. Postoperative follow-up showed gradually functional recovery of the lingual nerve.

Key words: Lingual nerve injuries, Neuroanastomosis, Magnetic resonance neurography, Alveolar surgery

Zhihao Yue, Jing Wang, Ziyu Yan, Na Ge, Xiangliang Xu, Xiaofeng Shan, Nianhui Cui. Application of magnetic resonance neurography in early diagnosis and therapy in a case of lingual nerve injury[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(06): 413-417.

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References 22

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时间点	感觉减退	感觉异常	病理性感觉异常	其他异常	触觉	痛觉	味觉	两点辨别觉（mm）	空间方向觉（正确次数/检查次数）	MRCS评分
术前	麻木	麻刺感	刺痛、电击样痛	自发痛感、凉感；咬舌；舌体烫伤	缺失	缺失	缺失	>15	0/5	S1
术后1个月	麻木稍有改善	无	无	偶有咬舌	缺失	迟钝	缺失	7	2/5	S3+
术后7个月	麻木明显改善	无	无	偶有咬舌	迟钝	迟钝	缺失	5	9/10	S4

时间点	感觉减退	感觉异常	病理性感觉异常	其他异常	触觉	痛觉	味觉	两点辨别觉（mm）	空间方向觉（正确次数/检查次数）	MRCS评分
术前	麻木	麻刺感	刺痛、电击样痛	自发痛感、凉感；咬舌；舌体烫伤	缺失	缺失	缺失	>15	0/5	S1
术后1个月	麻木稍有改善	无	无	偶有咬舌	缺失	迟钝	缺失	7	2/5	S3+
术后7个月	麻木明显改善	无	无	偶有咬舌	迟钝	迟钝	缺失	5	9/10	S4

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