Characteristics of patients referred to a UK trigeminal nerve injury service

Abstract

AbstractAim: Patients suffering from a persistent sensory disturbance or pain following a trigeminal nerve injury are frequently referred to a specialist centre for evaluation. This study reports the characteristics of the patients seen on a designated nerve injury clinic during 2008.Methods: Information from 100 consecutive patients was collated, including demographic details, source of referral, nerve damaged, cause of the injury, presence or absence of dysaesthesia and nature of the treatment, if offered.Results: There were 70 females and 30 males, with a mean age at presentation of 42 years (range 21–78 years). Sixty‐five per cent of referrals were from a consultant, and patients travelled from a wide geographical distribution across England, Wales and Ireland. The delay between nerve injury and referral ranged from 1 month to 5 years. Fifty‐six per cent of the patients had sustained an inferior alveolar nerve (IAN) injury and 44% had a lingual nerve injury. Most injuries (59%) were caused by lower third molar removal, but there were numerous other causes, including 10% associated with local anaesthetic administration. A similar proportion of patients reported symptoms of dysaesthesia after lingual nerve (41%) and IAN (45%) injuries. Only 41% of patients were treated (52% of lingual nerve injuries and 32% of IAN injuries), and this usually involved microsurgical repair (lingual nerve injuries) or decompression and neurolysis (IAN injuries).Conclusions: The highly selected population of patients that received tertiary referral to a specialist nerve injury clinic were most commonly female and 30–50 years old. A substantial proportion had dysaesthesia, and these patients were most likely to be offered treatment.