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Simple Qualitative Sensory Assessment of Patients with Orofacial Sensory Dysfunction

  • Im, Yeong-Gwan (Department of Oral Medicine, Dental Science Research Institute, School of Dentistry, Chonnam National University) ;
  • Kim, Byung-Gook (Department of Oral Medicine, Dental Science Research Institute, School of Dentistry, Chonnam National University) ;
  • Kim, Jae-Hyung (Department of Oral Medicine, Dental Science Research Institute, School of Dentistry, Chonnam National University)
  • Received : 2021.12.08
  • Accepted : 2021.12.18
  • Published : 2021.12.30

Abstract

Purpose: Oral and facial sensation is affected by various factors, including trauma and disease. This study assessed the clinical profile of patients diagnosed with sensory dysfunction and investigated their sensory perception using simple qualitative sensory tests. Methods: Based on a retrospective review of the medical records, we analyzed a total of 68 trigeminal nerve branches associated with sensory dysfunction in 52 subjects. We analyzed the frequency and etiology of sensory dysfunction, and the frequency of different types of sensory perception in response to qualitative sensory testing using tactile and pin-prick stimuli. Results: The inferior alveolar nerve branch was the most frequently involved in sensory dysfunction (88.5%). Third molar extraction (36.5%) and implant surgery (36.5%) were the most frequent etiological factors associated with sensory dysfunction. Hypoesthesia was the most frequent sensory response to tactile stimuli (60.3%). Pin-prick stimuli elicited hyperalgesia, hypoalgesia, and analgesia in 32.4%, 27.9%, and 36.8%, respectively. A significant association was found between the two kinds of stimuli (p=0.260). Conclusions: Sensory dysfunction frequently occurs in the branches of the trigeminal nerve, including the inferior alveolar nerve, mainly due to trauma associated with dental treatment. Simple qualitative sensory testing can be conveniently used to screen sensory dysfunction in patients with altered sensation involving oral and facial regions.

Keywords

Acknowledgement

We thank Jisoo Kim in the Department of Education & Research, Chonnam National University Dental Hospital for processing the medical record data.

References

  1. Alvarez FK, de Siqueira SR, Okada M, Teixeira MJ, de Siqueira JT. Evaluation of the sensation in patients with trigeminal post-herpetic neuralgia. J Oral Pathol Med 2007;36:347-350. https://doi.org/10.1111/j.1600-0714.2006.00489.x
  2. Azhary H, Farooq MU, Bhanushali M, Majid A, Kassab MY. Peripheral neuropathy: differential diagnosis and management. Am Fam Physician 2010;81:887-892.
  3. Hillerup S. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases. Clin Oral Investig 2007;11:133-142. https://doi.org/10.1007/s00784-006-0089-5
  4. Kim YK, Kim SG, Kim JH. Altered sensation after orthognathic surgery. J Oral Maxillofac Surg 2011;69:893-898. https://doi.org/10.1016/j.joms.2010.10.025
  5. Petersen LO, Ipsen EO, Felding UA, von Buchwald C, Steinmetz J. Sequelae of major trauma patients with maxillofacial fractures. Ann Otol Rhinol Laryngol 2021;130:475-482. https://doi.org/10.1177/0003489420958732
  6. Silva NSV, da Silva LA, Jaluul O, Jacob-Filho W, Siqueira SRDT. Oral infections, comorbidities and sensory evidences in elderly: cross-sectional study. Arch Gerontol Geriatr 2017;73:15-20. https://doi.org/10.1016/j.archger.2017.06.011
  7. Tay AB, Lai JB, Lye KW, et al. Inferior alveolar nerve injury in trauma-induced mandible fractures. J Oral Maxillofac Surg 2015;73:1328-1340. https://doi.org/10.1016/j.joms.2015.02.003
  8. Essick GK, Phillips C, Turvey TA, Tucker M. Facial altered sensation and sensory impairment after orthognathic surgery. Int J Oral Maxillofac Surg 2007;36:577-582. https://doi.org/10.1016/j.ijom.2007.02.006
  9. Svensson P, Baad-Hansen L, Pigg M, et al.; Special Interest Group of Oro-facial Pain. Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions--a taskforce report. J Oral Rehabil 2011;38:366-394. https://doi.org/10.1111/j.1365-2842.2010.02196.x
  10. Van der Cruyssen F, Van Tieghem L, Croonenborghs TM, et al. Orofacial quantitative sensory testing: current evidence and future perspectives. Eur J Pain 2020;24:1425-1439. https://doi.org/10.1002/ejp.1611
  11. Kim YK, Yun PY, Kim JH, Lee JY, Lee W. The quantitative sensory testing is an efficient objective method for assessment of nerve injury. Maxillofac Plast Reconstr Surg 2015;37:13. https://doi.org/10.1186/s40902-015-0013-5
  12. Rolke R, Baron R, Maier C, et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain 2006;123:231-243. https://doi.org/10.1016/j.pain.2006.01.041
  13. Rolke R, Magerl W, Campbell KA, et al. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 2006;10:77-88. https://doi.org/10.1016/j.ejpain.2005.02.003
  14. Jaaskelainen SK. The utility of clinical neurophysiological and quantitative sensory testing for trigeminal neuropathy. J Orofac Pain 2004;18:355-359.
  15. Yekta SS, Koch F, Grosjean MB, et al. Analysis of trigeminal nerve disorders after oral and maxillofacial intervention. Head Face Med 2010;6:24. https://doi.org/10.1186/1746-160X-6-24
  16. Jacobs R, Wu CH, Goossens K, Van Loven K, Van Hees J, Van Steenberghe D. Oral mucosal versus cutaneous sensory testing: a review of the literature. J Oral Rehabil 2002;29:923-950. https://doi.org/10.1046/j.1365-2842.2002.00960.x
  17. Baad-Hansen L, Pigg M, Ivanovic SE, et al. Chairside intraoral qualitative somatosensory testing: reliability and comparison between patients with atypical odontalgia and healthy controls. J Orofac Pain 2013;27:165-170. https://doi.org/10.11607/jop.1062
  18. Van der Cruyssen F, Peeters F, De Laat A, Jacobs R, Politis C, Renton T. Prognostic factors, symptom evolution, and quality of life of posttraumatic trigeminal neuropathy. Pain 2021. doi: 10.1097/j.pain.0000000000002408. [Epub ahead of print]
  19. Klazen Y, Van der Cruyssen F, Vranckx M, et al. Iatrogenic trigeminal post-traumatic neuropathy: a retrospective two-year cohort study. Int J Oral Maxillofac Surg 2018;47:789-793. https://doi.org/10.1016/j.ijom.2018.02.004
  20. Choi YC, Kwon JS, Kim ST, Ahn HJ. Analysis of patients with dysesthesia after mandibular nerve injury. J Oral Med Pain 2009;34:379-385.
  21. Hall JE, Hall ME. Guyton and Hall textbook of medical physiology. 14th ed. Philadelphia: Elsevier; 2021. pp. 599-600.
  22. Feher J. Quantitative human physiology: an introduction. San Diego: Academic Press; 2012. pp. 321-331.
  23. Meewis J, Renton T, Jacobs R, Politis C, Van der Cruyssen F. Posttraumatic trigeminal neuropathy: correlation between objective and subjective assessments and a prediction model for neurosensory recovery. J Headache Pain 2021;22:44. https://doi.org/10.1186/s10194-021-01261-3
  24. Syriatowicz JP, Hu D, Walker JS, Tracey DJ. Hyperalgesia due to nerve injury: role of prostaglandins. Neuroscience 1999;94:587-594. https://doi.org/10.1016/S0306-4522(99)00365-6
  25. Hulse RP. Identification of mechano-sensitive C fibre sensitization and contribution to nerve injury-induced mechanical hyperalgesia. Eur J Pain 2016;20:615-625. https://doi.org/10.1002/ejp.779
  26. Agbaje J, De Laat A, Constantinus P, Svensson P, Baad-Hansen L. Agreement between quantitative and qualitative sensory testing of changes in oro-facial somatosensory sensitivity. J Oral Rehabil 2017;44:30-42. https://doi.org/10.1111/joor.12455
  27. Ziccardi VB, Hullett JS, Gomes J. Physical neurosensory testing versus current perception threshold assessment in trigeminal nerve injuries related to dental treatment: a retrospective study. Quintessence Int 2009;40:603-609.
  28. Ziccardi VB, Dragoo J, Eliav E, Benoliel R. Comparison of current perception threshold electrical testing to clinical sensory testing for lingual nerve injuries. J Oral Maxillofac Surg 2012;70:289-294. https://doi.org/10.1016/j.joms.2011.08.019