The Use of an Ultrasonic Bone Curette in the Surgery of Jaw Tumors Involving the Inferior Alveolar Nerve

Abstract

Preservation of lip sensation is crucial in ablative surgery of mandibular tumors. When tumor control does not necessitate sacrifice of the inferior alveolar nerve (IAN), as in some cases of benign tumors of the lower jaw, attempts may be made to spare the nerve. The authors present and discuss their experience with an ultrasonic device in the treatment of benign tumors of the jaw in correspondence of the IAN. Five patients with tumoral lesions involving the IAN underwent surgery with an ultrasonic surgical device (Sonopet Omni Surgical System; Stryker, Kalamazoo, MI). Fine, delicate movements allowed the surgeon to remove bone without damage to surrounding tissue. Three of 5 patients did not present intraoperative or postoperative complications that could be attributed to the Sonopet. Two cases were partial failures. In 1 case, postoperative dysesthesia was encountered, and in the other case, intraoperative transection of the nerve occurred. The Sonopet ultrasonic bone curette proved to be highly useful in surgical procedures close to the IAN because it does not produce heat or cause mechanical injury to the neurovascular bundle. Application of this instrument may provide improved ability to preserve sensibility of the chin and lower lip in patients affected by lesions in proximity to the IAN.