Altered sensation of the inferior alveolar nerve in sagittal spilt osteotomies: a review of cases at a major UK centre over 10 years
Shammout, Masa Abdullah, Jeffrey Shammout, Aya Williams, Rhodri Mcmillan, Kevin
Shammout, Masa
Abdullah, Jeffrey
Shammout, Aya
Williams, Rhodri
Mcmillan, Kevin
Abstract
Inferior alveolar nerve (IAN) injuries are common complications of orthognathic surgery, with incidences reported from 0% to 85% due to inconsistent definitions, assessment methods and follow-up protocols. These limitations hinder comparisons, emphasising the need for standardised evaluation. This 10-year retrospective cohort study investigates IAN injury rates following mandibular osteotomies, focusing on medium-long term outcomes and risk factors. A retrospective cohort study was conducted at a tertiary orthognathic centre (2014-2024) on sagittal split osteotomies, performed either as stand-alone or as part of bimaxillary surgeries. Altered sensation was assessed via patient-reported outcomes during clinical follow ups (0-60+ months). While a final review was typically conducted at 6 months, extended follow ups addressed nerve symptoms, revision surgeries, or COVID-19 disruptions. Chi squared tests, Fisher's exact test and odds ratios evaluated associations with demographics, split quality, and nerve injuries. The primary outcome was altered sensation at ≥6 months. Of 221 procedures, 75.6% (n = 167) had follow ups ≥6 months, with 44.3% (n = 74/167) reporting altered sensation, primarily in the lower lip. Rates were 49% (n = 49/100) at 6-12 months, 50% (n = 13/26) at 13-18 months, and 29.2% (12/41) beyond 18 months. Females (OR = 1.07) and the 41-50 age group (50%, n = 2/4) showed slightly increased sensory changes, although they were not statistically significant. Unsatisfactory splits had higher altered sensation rates (60%, n = 6/10) compared with satisfactory splits (43.9%, n = 65/148) although these were not statistically significant (p = 0.15). Among documented nerve injuries, 100% (n = 7) resulted in sensory changes at ≥6 months. Altered sensation affected 44.3% (74/167); non-standardised follow up limits interpretation and supports standardised neurosensory reporting.
MIDER Authors
Date
2026-03-19
Type
Article
Collections
Citation
Shammout M, Abdullah J, Shammout A, Williams R, Mcmillan K. Altered sensation of the inferior alveolar nerve in sagittal spilt osteotomies: a review of cases at a major UK centre over 10 years. Br J Oral Maxillofac Surg. 2026 Mar 19:S0266-4356(26)00052-5. doi: 10.1016/j.bjoms.2026.03.004. Epub ahead of print.
Journal / Source Title
British Journal of Oral & Maxillofacial Surgery
DOI
10.1016/j.bjoms.2026.03.004
PMID
41946616
Publisher
Churchill Livingstone
Publisher’s URL
https://www.sciencedirect.com/journal/british-journal-of-oral-and-maxillofacial-surgery