A COMPARISON OF QUESTIONNAIRE VERSUS MONOFILAMENT ASSESSMENT OF NEUROSENSORY DEFICIT

Purpose: Because neurosensory deficit is commonly reported by patients after orthognathic surgery, it is important to know how accurately pa tients can report their own sensory deficit, This analysis compares th e results of objective neurosensory tests with the results of a subjec tive patient questionnaire. Materials and Methods: Before and 6 months after bilateral mandibular sagittal ramus split osteotomy, 101 patien ts with Class II facial deformities were asked to rate sensations of n umbness or tingling in the area of the mental nerve. Simultaneously, t hey were objectively tested using monofilament neurosensory tests (lig ht touch and brush stroke direction). Results: More than 70% of patien ts subjectively reported neurosensory problems, but objective assessme nt identified neurosensory deficits in less than 60% of the patients, The sensitivity and specificity of the patients' subjective assessment s were 75.3% and 52.8%, respectively, for the light touch test, and 77 .9% and 59.8%, respectively, for the brush stroke test. Conclusions: I t was concluded that when monfilament neurosensory testing is used as the gold standard, patients appear to overreport neurosensory problems ; ie, the positive predictive value of patient reports is only 63.2%, resulting in frequent false positives.