What Is a Safe Distance for Preservation of the Inferior Alveolar Nerve in Lower Gingival Squamous Cell Carcinoma? A Radiographic and Histopathological Study

Electroacupuncture Protocol for Sensory and Motor Function Recovery After Orthognathic Surgery: a Randomized Clinical Trial

Importance

Orthognathic surgery is utilized to rectify facial deformities, but it can lead to neurosensory alterations. Electroacupuncture has been shown to enhance sensitivity and motor functions in patients post-surgery. However, its application in traumatic facial injuries remains inadequately researched.

Objective

To investigate the effects of electroacupuncture on sensitivity and orofacial function in patients undergoing orthognathic surgery.

Design, Setting, and Population

A randomized clinical trial involving patients undergoing bimaxillary orthognathic surgery and genioplasty who are randomly allocated to either a physiotherapy (PT) or physiotherapy plus electroacupuncture group (PTEA).

Exposures

Participants will be allocated to their respective therapies for a duration of six weeks. The PT group will receive a 50-minute physical therapy session along with 30 minutes of simulated procedure. The PTEA group will receive 50 minutes of physical therapy followed by 30 minutes of electroacupuncture.

Main Outcomes and Measures

Before treatment, sensitivity will be assessed using the SMILE Sensitivity Test-BAURU kit, edema will be evaluated using the MD Anderson Cancer Center Head and Neck Lymphedema protocol, range of motion will be measured using a digital caliper, and muscle pain and fatigue will be gauged using numerical scales. The chewing function will be evaluated using the Chewing Quality Assessment Questionnaire.

Results

All assessments will be repeated at three and six months following the initiation of treatment.

Conclusions and Relevance

This study may provide reliable and high-quality clinical evidence regarding the impact of electroacupuncture on restoring altered sensation and motor function in patients undergoing orthognathic surgery.

Does Preservation of the Inferior Alveolar Nerve in the Close Margin of the Mandibular Ameloblastoma Increase the Risk of Recurrence?

PURPOSE

Preservation of the inferior alveolar nerve (IAN) during mandibular resection improves the patient's quality of life. This study aimed to assess the risk of recurrence in patients with or without IAN preservation following mandibular resection for the treatment of ameloblastoma.

METHODS

In this retrospective cohort study, patients with biopsy-proven, intraosseous, multicystic ameloblastoma in the mandible, without IAN involvement, were included. The minimum follow-up period was 36 months. In preserved group, the IAN was saved in the close margin, and the IAN was resected in the sacrificed group. The mandibular nerve management (preservation or sacrifice of the IAN) was a primary predictive variable. The primary outcome variable was time to recurrence of the jaw lesion. Age, sex, tumor size, and ameloblastoma histological subtype were covariates. A time-to-event analysis (Cox regression analysis) was performed to determine the risk of recurrence with or without preservation of the IAN.

RESULTS

Thirty-seven patients in the preserved group and 38 in the sacrificed group were included in this study. The median follow-up period was 43 months. The mean tumor size was 3.88 ± 0.89 cm in the preserved group, and the mean tumor size was 3.74 ± 0.56 cm in the sacrificed group. There was no significant difference in the mean tumor size between the 2 groups. The time-to-event analysis, based on the Cox regression analysis of covariates, did not approve the study's null hypothesis (an increased recurrence with IAN preservation; hazard ratio: 0.77 [0.20-2.93]; P = .71).

CONCLUSION

Based on the present results, preservation or sacrifice of the IAN in the close margin of mandibular ameloblastoma was not associated with an increased recurrence of lesions.