拔牙术后舌神经功能障碍的诊治进展

Research progress on diagnosis and management of post-exodontic lingual nerve dysfunction

摘要

舌神经功能障碍（LND）是牙拔除术的并发症之一，主要表现为同侧舌神经支配区域出现麻木、刺痛等异常感觉，可伴有味觉功能减退甚至丧失。LND的症状可因舌体机械运动频繁及口腔局部刺激较多而加重，对患者的生活质量和心理产生负面影响，大部分患者心理接受度差且改善症状的需求迫切。LND成因复杂，临床表现多样，虽然近年来神经修复技术有所进展，但修复机制未完全明确，治疗效果难以预测，因此对其进行病情评估、预后判断和治疗一直是临床的难点。本文回顾了近年来LND的研究进展，分析其成因和临床表现，重点就LND的临床评估、治疗方法（包括非手术治疗和手术治疗方法）、预后状况进行综述。

Abstract

Lingual nerve dysfunction (LND) belongs to the complications resulting from tooth extraction surgery. This condition is mainly characterized by abnormal sensations, such as numbness and tingling of the ipsilateral lingual nerve innervation area, with or without decreased/loss of taste. The symptoms of LND can be evoked or improved through frequent movements of the tongue and excessive local stimulation. LND poses negative effects, which are usually intolerable, on the quality of life and psychology of patients. Such condition prompts patients to seek medical assistance to alle-viate or eliminate their discomfort. LND is caused by complex conditions and involves diverse clinical manifestations. Despite the progress of nerve reconstruction techniques, the mechanism underlying the functional recovery of lingual nerve remains incompletely understood, and the treatment effect is still unpredictable. Therefore, the risk prediction, syndrome assessment, treatment, and prognosis of LND still present a challenge to dentists and clinicians. This article reviews the research progress on LND, including its etiology, manifestations, clinical evaluation, treatment methods (including nonsurgical and surgical treatment methods), and prognosis.

关键词

第三磨牙 / 牙拔除术 / 并发症 / 舌神经 / 神经功能障碍 / 神经修复

Key words

the third molar / tooth extraction / complications / lingual nerve / nerve dysfunction / nerve repair

Author summay

高丽钞，住院医师，学士，Email：[e-mail]