Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제28권1호
  • /
  • Pages.53-60
  • /
  • 2002
  • /
  • 2234-7550(pISSN)
  • /
  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

하치조 신경손상에 따른 하순 및 이부의 지각이상시 적외선 체열검사(DITI)의 진단적 효용

DIAGNOSTIC EFFICACY OF DITI (DIGITAL INFRARED THERMOGRAPHIC IMAGING) FOR THE DYSESTHESIA OF THE LOWER LIP & CHIN

  • 김예원 (이화여자대학교 대학원 의학과 치과학교실) ;
  • 김명래 (이화여자대학교 대학원 의학과 치과학교실)
  • Kim, Yae-Won (Dept. of Medicine, The Graduate School of Ewha Womans University) ;
  • Kim, Myung-Rae (Dept. of Medicine, The Graduate School of Ewha Womans University)
  • 발행 : 2002.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

키워드

참고문헌

  1. Bennet, A.J., Wastell, D.J., Barker, G.R., Blackburn, C.W., Rood, J.P. : Trigeminal somatosensory evoked potentials. Int J Oral Maxillofac Surg 16 : 408, 1987
  2. Alling Ⅲ, C.C. : Dysesthesia of the lingual & inferior alveolar nerve following third molar surgery. J Oral Maxillofac Surg 44 :454-457, 1986
  3. Osborn, T.P., Fredrickson, G., Small, I.A., Torgerson, T.S. : A prospective study of complications related to mandibular third molar surgery. J Oral Maxillofac Surg 43 : 767-769, 1985
  4. Kenneth, E., Fleisher, Mark, R., Stevens : Diagnosis and Management of inferior alveolar nerve injury. Compendium 16(10):1028-104, 1995
  5. Ghali, G.E., Jones, D.L., Wolford, L.M. : Somatosensory evoked potential assessment of the inferior alveolar nerve following third molar extraction. Int J Oral Maxillofac Surg 19 : 18-21, 1990
  6. Pogrel, M.A., Renaut, A., Ammar, A.A. : The relationship of the lingual nerve to the mandibular third molar region: an anatomy study. J Oral Maxillofac Surg 53 : 1178-1181, 1995
  7. Schwartz, L.J. : Lingual anesthesia following mandibular odontectomy. J Oral Surg 31 : 918-920, 1973
  8. Zaytoun, H.S., Phillips, C., Terry, B.C. : Long-term neurosensory deficits following transoral vertical ramus and sagittal split osteotomies for mandibular prognathism. J Oral Maxillofac Surg 44:193-6, 1986
  9. Coghlan, K.M., Irvine, G.H.: Neurological damage after sagittal split osteomy. Int J. Oral Maxillofac Surg 15 : 369-71, 1986
  10. Godfrey, R.M., Mitchell, K.W. : Somatosensory evoked potentials to electrical stimulation of the mental nerve. Br J Oral Maxillofac Surg 25 : 300, 1987
  11. Jaaskelainen, S.K., Peltola, J.K. : clinical application of the blink reflex with stimulation of the mental nerve in lesions of the inferior alveolar nerve. Neurology 44 : 2356-2361, 1994
  12. Jones, D.L., Wolford, L.M. : Intraoperative recording of trigeminal evoked potentials during orthognathic surgery. Int J Adult orthod Orthognath Surg 5 : 167-174, 1990
  13. Schultze-Mosgau, Reich, R.H. : Assessment of inferior alveolar and lingual nerve disturbances after dentoalveolar surgery, and of recovery of sensitivity. Int J Oral & Maxillofac Surg 22 : 214-17, 1993
  14. 김명래 : 하악구치부 수술후 하순지각마비의 진단적 평가와 치료. 대한 치과의사협회지 28(12) : 107-114, 1990
  15. Reed, H. : Diagnosis and Treatment of frigerminal nerve injurles. 22(6):48-54. 1994
  16. Walter, J.M.Jr., Gregg, J.M. : Analysis of post surgical neurologic alteration in the trigerminal nerve. J Oral Surg 37 : 410-414,1979
  17. Robinson, P.P. : Observations on the recovery of sensatin following inferior nerve injuries. Br J Oral Maxillofac Surg 26 : 177-89, 1988
  18. Gratt, B.M., Sickles, E.A. : Electronic Facial Thermography: An analysis of asymptomatic adult subjects. J of Orofacial Pain 9(3):255 -265, 1995
  19. Gratt, B., Shetty, V, Saiar, M, et al. : Electronic thermography for the assessment of inferior alveolar nerve deficit. Oral Surg 80 : 153, 1995
  20. Fagade, O.O., Wastell, D.G. : Trigerminal somatosensory evoked potential : technical parameters, reliability & potential in clinical dentistry. J Dent 18 : 137-141, 1990
  21. Barker, G.R., Bennet, A.J.,Wastell, D.J. : Applications of trigerminal somatosensory evoked potentials (TSEPs) in oral & maxillofacial surgery. Br J Oral Maxillofac Surg 25 : 308-313, 1987
  22. Altenmuller, C.P., Cornelius, U.W., Buettner. : Somatosensory eveked potentials following tongue stimulation in normal subjects and patients with lesions of the afferent trigeminal system. Electroencephalogr Clin Neurophysiol 77 : 403-415, 1990
  23. Jaaskelainen, S.K. : Blink reflex with stimulation of the mental nerve. Methdology , reference values, and some clinical vignettes. Acta Neurol Scand 91 : 477-482, 1995
  24. Gratt, B.M., Anbar, M. : Thermology and facial telethermography : Part Ⅱ. Current and future Clinical apptications in dentistry. Dentomaxillofacial Radiology 27 : 68-74, 1998
  25. Robert, G. Ford. : Thermography in the Diapnosis of Headache. Seminars in Neurology 17(4) : 343-349, 1997
  26. Biagioni, P.A., Longmore, R.B. : Infrared thermography. Its role in dental research with particalar reference to craniomandibular disorders. Dentomaxillofac Radiol 25(3) : 119-124, 1995
  27. White, B.A., Lockhart, P.B., Connolly, S.F., Sonis, S.T. : The use of infrared thermography in the evaluation of oral lesions. JADA 113 : 783-786, 1986
  28. 이규창. : 통증과 DITI. 건국의과학학술지 3 : 13-21, 1993.
  29. Fischer, A.A., Chang, C.H., Kuo, J.C. : Value of thermography in diagnosis of radiculopathy as compared with electro diagnosis. Arch Phys Med Rehabil 64 : 526, 1983
  30. Brelsford, K.L., Uematsu, S. : Thermographic presentation of cutaneous sensory and vasomotor activity in the injured peripheral nerve. J Neurosurg 62 : 711-715, 1985 https://doi.org/10.3171/jns.1985.62.5.0711
  31. Pochaczevsky, R., Wexler, C.E., Meyers, P.H., et al. : Liquid crystal thermography of the spine and extremities. Its value in the diagnosis of spinal root syndromes. J Neurosurg 56 :386-395,1982
  32. Wastell, D.G., Bennett, A.J., Barker, G.R. : Early experiences using trigeminal somatosensory evoked potentials to assess sensory deficit. Electroenceph clin Neurophysiol 63 : 79, 1598
  33. Bennet, A.J., Wastell, D.J., Barker, G.R., Blackburn, C.W., Rood, J.P. : Trigeminal somatosensory evoked potentials. Int J Oral Maxillofac Surg 16 : 408, 1987
  34. Zuniga, J.R. : Normal response to nerve injury. Oral and Maxillofacial Surgery Clinics of North America 4 : 323, 1992
  35. Ghali, G.E., Epker, B.N. : Clinical neurosensory testing : practical applications. J Oral Maxillofac Surg 47 : 1074-1078, 1989
  36. Campbell, R.L., Shamaskin, R.G., Harkins, S.W. : Assessment of recovery from injury to inferior alveolar and mental nerve. Oral Surg. Oral Med. Oral Pathol 64 : 519-526, 1987
  37. Crandell, C.E., Hill, R.P. : Thermography in dentistry:a pilot study. Oral Surg. Oral Med. Oral Pathol 21 : 316-20, 1966
  38. Irwin, J.W., Savara, B.S., Bartley, M.H., Rau, J.A. : Intraoral thermography. Oral Surg 32 : 724-30, 1971
  39. Berry, D.C., Yemm, R. : Variations in skin temperature of the face in normal subjects and in patients with mandibular dysfunction. Br J Oral surg 8 : 242-247, 1971 https://doi.org/10.1016/S0007-117X(70)80086-5
  40. Kopp, S., Haraldson, T. : Normal variation in skin surface temperature over the temporomandibular joint and masseter muscle. Scand J Dent Res 91 : 308-11, 1983
  41. Gratt, B.M., Sickles, E.A , Ross, J.B. : Electronic thermography in the assessment of internal derangement of the TMJ. Oral Sur Oral Med Oral Pathol 71 : 364-370, 1991
  42. Weinstein, S.A., Gelb, M., Weinstein, G., Weinstein, E.L. : Thermophysiologic anthropometry of the face in Homo sapiens. J Craniomandibular Pract, 8:252-7, 1990
  43. Uematsu, S., Baden, E., Brelsford, K. et al. : Reproducibility of skin temperature symmetry during a one-year period. American Academy of Thermatology 99-114, 1986
  44. Gratt, B.M. : A 6-year Clinical assessment of electionic facial thermography. Dentomaxillofac Radiol 25 : 247-255, 1996
  45. Gratt, B.M., Sickles, E.A., Wexler, C.E., Ross, J. : Thermographic characterization of internal derangement of the temporomandibular joint. J Orofacial Pain 8 : 206-215, 1994
  46. Gratt, B.M., Sickles, E.A., Shetty, V. : Thermography for the clinical assessment of inferior alveolar nerve deficit: a pilot study. J. Orofacial Pain 8 : 369-74, 1994
  47. 김영수,∙조용은. : 요추간반 탈출증 환자에서 수술전후 컴퓨터 적외선 신 체열 촬영 소견. 대한신경외과학회지 22 : 71-82, 1993
  48. Uematsu, S., Baden, E., Brelsford, K. et al. : Reproducibility of skin temperature symmetry during a one-year period. In: Abernathy M. Uematsu S. eds. Medical Thermology. Washington DC: American Academy of Thermology 99-114 , 1986
  49. 유충선, 전병환, 서성우, 이화동, 김한규, 황용순, 문재곤. 파열 유리된 추디스크 예측에 대한 컴퓨터 적외선 전신체열촬영검사의 의의. 대한 경외과학회지 25(1) : 138-143, 1996
  50. 전세일, 박은숙, 이창헌. 정상 성인에서 컴퓨터 적외선 체열촬영검사에 한 체표온도측정. 대한활할의학회지 19 : 425-430, 1995
  51. Pedersen, H., Blunk, C., Gardner, E. : Anatomy of lumbosacral posterior rami and meningeal branches of spinal nerves. J Bone Joint Surg 38A : 377-390, 1956
  52. Uematsu, S., Edwin, D.H., Jankel, W.R., et al. : Quantification of thermal asymmetry. Part 1; Normal value and reproducibility. J. Neurosurg 69 : 552-555, 1988
  53. IdeC. : Peripheral nerve regeneration. Neuro Sicence Research 25 : 101-121, 1996