Anatomical Study of the Feasibility of Contralateral Mental Nerve Coaptation With Magnetoencephalography of Patients With Unilateral Innervation of the Mental Nerve Dermatome

Abstract

Segmental hemimandibulectomy with sacrifice of the IAN results in postoperative anesthesia of the lower lip. Given the length of resection necessary for most segmental mandible tumor exonerations, the IAN is unable to sprout and span the segmental gap. There are case reports of patients regaining sensation to the lower lip after segmental mandibulectomy. The anatomical confines of the mental nerve area make re-innervation via collateral c-fiber sprouting across the midline from the contralateral IAN highly likely. This raises an interesting neurological question: on which side of the face will the patient perceive tactile sensation? A nerve typically gives rise to sensation on its own side of the face. If re-innervation is from the contralateral side but the sensation is perceived qualitatively by the patient on the damaged side, this would suggest for the first time that one hemisphere of the brain can produce somatosensory qualia that are perceived to originate from the ipsilateral side of the face, and that something about the nerve signal dictates the lateralization. In this study we attempt to test the feasibility of expediting the reafferentation of the contralateral anesthetized region, both anatomically and functionally.