이신경눈깜박임반사를 이용한 하치조신경 손상 평가
Mental nerve blink reflex for the diagnosis of the inferior alveolar nerve damage
조준혁, 정헌종, 김선경, 이주영, 김승수, 김종식, 변수환, 김성민, 김명진, 이종호,
소속 상세정보
조준혁 ( Cho Jun-Hyuk ) - 서울대학교 치의학대학원 치의학과
정헌종 ( Jung Hun-Jong ) - 건국대학교 의과대학 산업의학과
김선경 ( Kim Sun-Kyung ) - 서울대학교 치과병원 임상시험센터
이주영 ( Lee Ju-Young ) - 서울대학교 치의학대학원 구강해부학교실
김승수 ( Kim Soung-Soo ) - 서울대학교 치과병원 구강악안면외과
김종식 ( Kim Jong-Sik ) - 서울대학교 치과병원 구강악안면외과
변수환 ( Byun Soo-Hwan ) - 서울대학교 치과병원 구강악안면외과
김성민 ( Kim Soung-Min ) - 서울대학교 치과병원 구강악안면외과
김명진 ( Kim Myung-Jin ) - 서울대학교 치과병원 구강악안면외과
이종호 ( Lee Jong-Ho ) - 서울대학교 치과병원 구강악안면외과
KMID : 1025720140330010007
Abstract
Purpose: Many clinical tests have been developed since 1988, when Mackinnon and Dellon used a modified British Medical Research Council scale to grade injury and monitor sensory recovery following trigeminal nerve injuries. Yet little attention has been focused on standard clinical test for the diagnosis of inferior alveolar nerve damage. Recently, Jaaskelainen suggested the mental nerve blink reflex test as a new diagnostic tool for quantifying the degree of inferior alveolar nerve damage. In this study, the mental nerve blink reflex test was performed on the Korean population for the first time, and its effectiveness and clinical relevancy were confirmed.
Materials and Methods: This study mainly comprised of two experimental groups. In the first group, the mental nerve blink reflex test was performed on patients who underwent partial mandibulectomy for the treatment of squamous cell carcinoma involving the inferior alveolar nerve. The normal mental nerve blink reflex response was evaluated in the second group which consisted of 20 healthy volunteers, including 10 women and 10 men, without any neurological diseases. The mean age of the group was 29.5 years, ranging from 26 to 32 years. Neuro-EMG-micro (NeurosoftTM, Ivanovo, Russia) was used to measure the threshold current, delayed time, duration, and amplitude of mental nerve blink reflex response, and Neuro-MEPω (NeurosoftTM, Ivanovo, Russia) program was used to analyze the data.
Results: The first experimental group showed loss of mental nerve blink reflex after the surgery. In the second group, average values of 13 mA (standard deviation [SD]±8.68), 42.36 ms (SD±7.58), 38.85 ms (SD±12.41), and 198.65 mA (SD±116.08) were recorded for threshold current, delayed time, duration, and amplitude, respectively.
Conclusions: The mental nerve blink reflex test was able to clearly distinguish between anesthesia and normal blink reflex response. Upon analysis of normal response, only the delayed time showed statistical significance and possible relevance to the nerve injuries.
키워드
Inferior alveolar nerve; Mental nerve; Sensory test; Blink reflex; Mental nerve blink reflex test
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