Neurosensory recovery after ligation of the descending palatine neurovascular bundle during Le Fort I osteotomy

Purpose: The effect of ligating the descending palatine neurovascular bundl e (DPNB) on the recovery of palatal sensation has not been clearly establis hed. The purpose of this study was to determine the effect of ligation of t he DPNB on the recovery of palatal sensation after Le Fort I osteotomy. Patients and Methods: Using a retrospective study design in a randomized pr otocol, patients who had undergone Le Fort I osteotomy were assigned to eit her treatment group 1 (DPNB ligated) or treatment group 2 (DPNB preserved). A third group of control patients (group 3, unoperated) on whom no surgery had been performed served as a baseline for examination of normal palatal sensation. The predictor variables were ligation and preservation of the DP NB. The outcome variables were mean tactile sensation and mean nociception. Other study variables included age, sex, follow-up, surgical movements, an d number of segments. Results: There were 11 patients in group 1, 7 in group 2, and 10 in group 3 . For tactile sensation, the mean Von Frey hair size detected was 4.26 +/- 0.37, 4.11 +/- 0.17, and 3.68 +/- 0.24 for groups 1, 2, and 3, respectively . The difference between group 1 and group 2 was not significant (P > .05). The differences between group 1 and group 3 and between group 2 and group 3 were significant (P < .05). For nociception, the mean pressure was 51.09 +/- 21.73, 50.89 +/- 19.19, and 56.25 +/- 19.02 for groups 1, 2, and 3, res pectively. The difference between the 3 groups was not significant (P = .80 64). Conclusion: The results of this study suggest that recovery of palatal sens ation is not adversely affected by ligation of the DPNB. (C) 2000 American Association of Oral and Maxillofacial Surgeons.