Lingual nerve injury II. Observations on sensory recovery after microneurosurgical reconstruction

The aim of this study was to report on neurosensory recovery after microsurgical lingual nerve repair, and to evaluate the effect on recovery of age, delay in repair and gender of the patient. Seventy-four patients entered the study. The microsurgical repair performed was direct nerve suture (n = 71), external neurolysis (n = 2) and excision of neuroma without nerve coaptation (n = 1). A standardized neurosensory examination was employed in all patients before surgery and during follow up. Recovery was significant for perception of all tested stimuli: feather light touch, pin prick, pointed/dull discrimination, warm, cold, location of touch, and brush stroke direction, pain perception and two-point discrimination. The rate of recovery was highest during the first 6 months. Females were more often affected than males, but recovery was not influenced by gender. The distribution of neurogenic discomfort (paraesthesia, etc.) remained essentially unchanged. Disregarding cases with poor recovery, delay of surgery had a small but significant influence on the regain of neurosensory function of the lingual nerve whereas age had no such effect. None of the patients recovered to normal. Lingual nerve injury seriously affects the quality of life of patients, and micro-surgical repair is beneficial in the absence of spontaneous recovery.