📝 “What Causes a Traumatic Neuroma of the Inferior Alveolar Nerve?”

7.26.24 Quick Review #188 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #surgery #surgeon #omfs #neuroma #inferioralveolarnerve Traumatic neuroma of the inferior alveolar nerve typically arises following injury or surgical intervention in the mandibular region. Common causes: 1. Tooth Extraction: The most frequent cause, particularly involving the third molars (wisdom teeth). 2. Mandibular Fractures: Trauma leading to fractures can damage the inferior alveolar nerve. 3. Implant Placement: Surgical placement of dental implants can injure the nerve. 4. Orthognathic Surgery: Procedures to correct jaw alignment can inadvertently damage the nerve. 5. Endodontic Procedures: Root canal treatments or other procedures on the lower teeth can cause nerve injury. 6. Local Anesthetic Injections: Improper technique or needle placement can damage the nerve. Pathophysiology: After injury, nerve fibers attempt to regenerate. When the regeneration is disorganized or incomplete, it can lead to the formation of a traumatic neuroma. This benign growth consists of nerve tissue and scar tissue, resulting in an abnormal nerve healing response. Signs and Symptoms: 1. Pain: The most common symptom, ranging from mild discomfort to severe, chronic pain. It can be spontaneous or triggered by touch, pressure, or movement. 2. Paresthesia: Abnormal sensations such as tingling, burning, or “pins and needles” in the distribution area of the inferior alveolar nerve. 3. Hypoesthesia: Reduced sensation or numbness in the lower lip, chin, and gingival area of the mandibular teeth. 4. Dysesthesia: Unpleasant abnormal sensation, often painful, in the affected area. 5. Swelling or Mass: In some cases, a palpable mass or swelling may be present at the site of the neuroma. Diagnosis and Management: • Clinical Examination: Detailed patient history and physical examination focusing on sensory changes in the mandibular region. • Imaging: Radiographs or advanced imaging (like CBCT) to assess the nerve and surrounding structures. • Electrophysiological Testing: May be used to evaluate nerve function. References: 1. Tokuc, B., Altindis, S., Coskunse, F. M., & Sinanoglu, A. (2021). Excision of rare intraosseous traumatic neuroma of the mandible. Journal of Stomatology, Oral and Maxillofacial Surgery, 122(2), 199-202. 2. Pogrel, M. A., & Thamby, S. A. (2006). The etiology of neuromas: A review. Journal of Oral and Maxillofacial Surgery, 64(8), 1220-1223. 3. Renton, T., & Yilmaz, Z. (2012). Managing iatrogenic trigeminal nerve injury: A case series and review of the literature. International Journal of Oral and Maxillofacial Surgery, 41(5), 629-637. 4. Robinson, P. P., & Smith, K. G. (2017). Treatment of nerve injury during surgery: A review. British Journal of Oral and Maxillofacial Surgery, 55(4), 338-342. 5. ChatGPT. 2024. #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher