Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지

ASSESSMENT OF INFERIOR ALVEOLAR NERVE DAMAGE USING DIGITAL INFRARED THERMOGRAPHIC IMAGING

디지털 적외선 체열 검사를 사용한 하치조 신경 손상의 평가

  • Lee, Ji-Yeon (Department of Oral & Maxillofacial Surgery, School of Dentistry, Dankook University) ;
  • Lee, Jae-Hoon (Department of Oral & Maxillofacial Surgery, School of Dentistry, Dankook University) ;
  • Kim, Chul-Hwan (Department of Oral & Maxillofacial Surgery, School of Dentistry, Dankook University)
  • 이지연 (단국대학교 치과대학 구강악안면외과학교실) ;
  • 이재훈 (단국대학교 치과대학 구강악안면외과학교실) ;
  • 김철환 (단국대학교 치과대학 구강악안면외과학교실)
  • Published : 2004.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.

Keywords

References

  1. Robert L, Ronald G, Stephen W, et al.: Assessment of recovery from injury to inferior alveolar and mental nerves. Oral Surg Oral Med Oral Pathol 1987;64:519-526 https://doi.org/10.1016/0030-4220(87)90024-7
  2. 이종흔, 김종수: 구강 생리학, 서울:군자 출판사, 1994
  3. 권오진 유근식, 이양균: Trigger point에 대한 컴퓨터 적외선 전신촬영법의 임상적 의의에 대한 고찰. 대한재활의학회지 1991;15:527-33
  4. 김종문: 적외선 체열 촬영의 실제적 임상 활용. 대한한의진단학회지 2000;4(1):31-42
  5. Gratt BM, Shetty V, Pullinger A, Sickels EA, et al: Electronic thermography of normal facial structures: A pilot study. Oral Surg Oral Med Oral Pathol 1989;68:346-351 https://doi.org/10.1016/0030-4220(89)90222-3
  6. 김명국: 머리 및 목 해부학, 4판 서울:치의학사, 1995
  7. Eduard VC, Leonardo BA, Cosme GEl: Inferior alveolar nerve damage after lower third molar surgical extraction: A prospective study of 1117 surgical extractions. Oral Surg Oral Med Oral Pathol 2001;92:377-383 https://doi.org/10.1067/moe.2001.118284
  8. Hua Z, Song J, Liu Y, et al: Nerve injury and neurosensory recovery following bilateral mandibular sagittal split osteotomy. Zhonghua Zheng Xing Wai Ke Za Zhi 2002;18(5):291-3
  9. Campell RL, Shamaskin RG, Harkins SW: Assessment of recovary from injury to inferior alveolar nerve and mental nerves. Oral Surg Oral Med Oral Pathol 1987;64:510-26
  10. Seddon HJ: Three type of nerve injury. Brain 1943;66:237
  11. Sunderland S: A classification of peripheral nerve injuries producing loss of function. Brain 1951;74:491
  12. 김명래: 하악 구치부 수술 후 하순지각마비의 진단적 평가와 치료. 대한치과의사협회지 1990;28(12):1013-1019
  13. Ghali GE, Epker BN: Clinical neurosensory testing: Practical applications. J Oral Maxillofac Surg 1989;47:1074-1078 https://doi.org/10.1016/0278-2391(89)90184-5
  14. Shetty V, Barton MG, Virginia F: Thermographic assessment of reversible inferior alveolar nerve deficit. J of Orofacial Pain 1994;8(4):375-82
  15. Jones DL, Thrash WJ: Electrophysiological assessment of human inferior nerve function. J Oral Maxillofac Surg 1992;50:581-585 https://doi.org/10.1016/0278-2391(92)90437-5
  16. 정현주, 김명래: 하치조신경 손상시 턱끝신경 체성감각유발전위검사의 진단적 유용성에 관한 연구. 대구외지 2001;27(3):250-57
  17. 김혜원, 강세윤, 고영진 등: 건강한 한국인의 턱끝신경 자극에 의한 안륜근 반사. J of Korean Acad of Rehab 1996;20(4):898-903
  18. Jaaskelainen S: Blink reflex with stimulation of the mental nerve. Methodology, reference values, and some clinical vignettes. Acta Neurol Scand 1995;91:477-82 https://doi.org/10.1111/j.1600-0404.1995.tb00449.x
  19. Jaaskelainen S: Clinical application of blink reflex with stimulation of the mental nerve in lesion of the inferior alveolar nerve. Neurology 1994;44:2356-2361 https://doi.org/10.1212/WNL.44.12.2356
  20. Anbar M, Gratt BM, Hong D: Thermology and facial telethermography. Part I: history and technical review. Dentomaxillofacial Radiology Mar 1998;27(2):61-67 https://doi.org/10.1038/sj.dmfr.4600314
  21. Anbar M, Gratt BM: Thermology and facial telethermography. Part II: Current and future clinical applications in dentistry. Dentomaxillofacial Radiology Mar 1998;27(2):68-74 https://doi.org/10.1038/sj.dmfr.4600324
  22. Kirsch KA: Physiology of skin-temperature. Applied Thermology: Thermologic Methods. 1985;pp1-9
  23. Hardy JD: The radiation of heat from the human body. J Clinical Invest 1936;15:1-8 https://doi.org/10.1172/JCI100746
  24. Uematsu S: Thermographic imaging of cutaneous sensory segment in patient with peripheral injury. J Neurosurg 1985;62:716-720 https://doi.org/10.3171/jns.1985.62.5.0716
  25. Uematsu S, Edwin DH, Jankel WR, et al: Quantification of thermal asymmetry. Part I: normal values and reproducibility. J Neurosurg 1988;69:552-555 https://doi.org/10.3171/jns.1988.69.4.0552
  26. Gratt BM, Sickles EA: Electronic facial thermography: an analysis of asymptomatic adult subjects. J Orofac Pain Summer 1995;9(3):255-65
  27. 박영주, 우남식, 이예철: 체열촬영술을 이용한 성상신경절 차단의 평가. 대한통증학회지 1994;7(2):259-262
  28. Gratt BM, Shetty V, Saiar M, et al.: Electronic Thermography for the assessment of inferior alveolar deficit. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Aug 1995;80(2):153-60
  29. Pochaczevsky R, Wexler CE, Meyers PH, et al: Liquid crystal thermography of the spine and extremities. Its value in the diagnosis of spinal root syndromes. J Neurosurg Mar 1982;56(3):386-95 https://doi.org/10.3171/jns.1982.56.3.0386
  30. Goodmann: Normal temperature asymmetry of the back and extrimies by computer assisted infrared imaging. Thermology 1986;1:195-202
  31. 이예철: 통증 치료실에서의 D.I.T.I.의 응용. 대한통증학회지 1992;5(2):199-205
  32. 조희경, 박찬희, 이준규 등: 체열 촬영술(Thermovision 782)을 이용한 통증의 진단과 치료. 대한통증학회지 1994;7(1):53-58
  33. 김예원, 김명래: 하치조 신경손상에 따른 하순 및 이부의 지각 이상시 적외선 체열검사(DITI)의 진단적 효용. 대구외지 2002;28:53-60