A prospective, quantitative study on the clinical outcome of lingual nerverepair

We previously showed in laboratory studies that the most effective method f or repair of damaged lingual nerves was by excision of the neuroma, mobiliz ation of the stumps, and direct reapposition with epineurial sutures, We ha ve now undertaken a prospective study in a series of 53 patients treated by this method and have evaluated the outcome by quantifying and comparing th e results of tests of sensation before and after operation. The outcome in individual patients was variable. However, pooled data from all patients sh owed a highly significant improvement in sensation at the final assessment 12 months or more after the repair. The proportion of patients who responde d to most or all light touch stimuli increased from 0% to 51% after repair, and the proportion who responded to pin-prick stimuli increased from 34% t o 77%, There was no correlation between the final results of any of the tes ts and the delay before repair, None of the patients regained completely no rmal sensation and there was no reduction in the number with spontaneous pa raesthesia or pain. However, fewer patients tended to bite the tongue by ac cident and most of them considered the operation worthwhile. These data sho w that lingual nerve repair is effective in most patients and we suggest th at it should be offered to all those who show few signs of spontaneous reco very after injury.