Trigeminal sensory recovery using processed nerve allografts for large continuity defects

The processed nerve allograft, Avance (AxoGen, Alachua, FL), has become a popular alternative to an autograft for the repair of nerve injuries, including the trigeminal nerve. Clinical outcome data on their safety and effectiveness in restoring sensory function of the trigeminal nerve is needed. Sensory assessments of trigeminal nerve injuries were conducted at pre-surgical, 3, 6, and 12 months post-surgical reconstruction with Avance® Nerve Graft. Subjects with at least 6 months of follow-up were included in this analysis. Assessments included brush stroke directional sensation (BSDS), static 2-point discrimination (s2PD), contact detection (CD), pressure pain threshold, and pressure pain tolerance. Adverse events were assessed. The study consisted of 18 subjects with 20 trigeminal nerve reconstructions, 2 subjects had 2 reconstructions. All injuries were reconstructed with processed nerve allograft. Fourteen subjects with 16 reconstructions had sufficient follow-up data for outcomes analysis. The subjects were 7 males and 7 females with 12 lingual nerve and 4 inferior alveolar nerve reconstructions. The mean age was 31+15 (9, 67) years old and the mean time between injury and surgery was 217+199 (0, 527) days. Twelve of the 16 reconstructions reported the gap length of injury, giving an average of 30+24 (15, 70) mm. Improvements in sensory function were reported in 14 out of the 16 reconstructions with processed nerve allograft (87%). Six repairs reported within normative ...
Source: International Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Source Type: research