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Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex

Iatrogenic injury of the inferior alveolar or lingual nerves frequently leads to legal actions for damage and compensation for personal suffering. The masseter inhibitory reflex (MIR) is the most used neurophysiological tool for the functional assessment of the trigeminal mandibular division. Aiming...

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Autores principales: Biasiotta, A., Cascone, P., Cecchi, R., Cruccu, G., Iannetti, G., Mariani, A., Spota, A., Truini, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139056/
https://www.ncbi.nlm.nih.gov/pubmed/21660431
http://dx.doi.org/10.1007/s10194-011-0354-0
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author Biasiotta, A.
Cascone, P.
Cecchi, R.
Cruccu, G.
Iannetti, G.
Mariani, A.
Spota, A.
Truini, A.
author_facet Biasiotta, A.
Cascone, P.
Cecchi, R.
Cruccu, G.
Iannetti, G.
Mariani, A.
Spota, A.
Truini, A.
author_sort Biasiotta, A.
collection PubMed
description Iatrogenic injury of the inferior alveolar or lingual nerves frequently leads to legal actions for damage and compensation for personal suffering. The masseter inhibitory reflex (MIR) is the most used neurophysiological tool for the functional assessment of the trigeminal mandibular division. Aiming at measuring the MIR sensitivity and specificity, we recorded this reflex after mental and tongue stimulations in a controlled, blinded study in 160 consecutive patients with sensory disturbances following dental procedures. The MIR latency was longer on the affected than the contralateral side (P < 0.0001). The overall specificity and sensitivity were 99 and 51%. Our findings indicate that MIR testing, showing an almost absolute specificity, reliably demonstrates nerve damage beyond doubt, whereas the relatively low sensitivity makes the finding of a normal MIR by no means sufficient to exclude nerve damage. Probably, the dysfunction of a small number of nerve fibres, insufficient to produce a MIR abnormality, may still engender important sensory disturbances. We propose that MIR testing, when used for legal purposes, be considered reliable in one direction only, i.e. abnormality does prove nerve damage, normality does not disprove it.
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spelling pubmed-31390562011-08-26 Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex Biasiotta, A. Cascone, P. Cecchi, R. Cruccu, G. Iannetti, G. Mariani, A. Spota, A. Truini, A. J Headache Pain Rapid Communication Iatrogenic injury of the inferior alveolar or lingual nerves frequently leads to legal actions for damage and compensation for personal suffering. The masseter inhibitory reflex (MIR) is the most used neurophysiological tool for the functional assessment of the trigeminal mandibular division. Aiming at measuring the MIR sensitivity and specificity, we recorded this reflex after mental and tongue stimulations in a controlled, blinded study in 160 consecutive patients with sensory disturbances following dental procedures. The MIR latency was longer on the affected than the contralateral side (P < 0.0001). The overall specificity and sensitivity were 99 and 51%. Our findings indicate that MIR testing, showing an almost absolute specificity, reliably demonstrates nerve damage beyond doubt, whereas the relatively low sensitivity makes the finding of a normal MIR by no means sufficient to exclude nerve damage. Probably, the dysfunction of a small number of nerve fibres, insufficient to produce a MIR abnormality, may still engender important sensory disturbances. We propose that MIR testing, when used for legal purposes, be considered reliable in one direction only, i.e. abnormality does prove nerve damage, normality does not disprove it. Springer Milan 2011-06-10 /pmc/articles/PMC3139056/ /pubmed/21660431 http://dx.doi.org/10.1007/s10194-011-0354-0 Text en © The Author(s) 2011 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Rapid Communication
Biasiotta, A.
Cascone, P.
Cecchi, R.
Cruccu, G.
Iannetti, G.
Mariani, A.
Spota, A.
Truini, A.
Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
title Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
title_full Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
title_fullStr Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
title_full_unstemmed Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
title_short Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
title_sort iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex
topic Rapid Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139056/
https://www.ncbi.nlm.nih.gov/pubmed/21660431
http://dx.doi.org/10.1007/s10194-011-0354-0
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