REDUCING LINGUAL NERVE DAMAGE IN 3RD MOLAR SURGERY - A CLINICAL AUDITOF 1350 CASES

Several publications reporting lingual nerve damage in the region of 1 1% caused the author to undertake a retrospective personal clinical au dit of 100 cases which demonstrated a comparable complication rate of 10%. This audit prompted a re-evaluation of the detailed surgical anat omy, the design and manufacture of a new type of periosteal elevator a nd lingual nerve retractor and a modification of the surgical techniqu e. A subsequent prospective personal clinical audit of 1001 consecutiv e wisdom tooth operations has resulted in a 20-fold improvement (0.5%) in the incidence of lingual nerve damage. The technique and instrumen tation has been used under local anaesthesia and under general anaesth esia by surgeons of varying experience and has a group audit complicat ion rate of only 1% in 300 consecutive cases. The value of clinical au dit has become self evident.