Trigeminal Nerve Injuries and Repair

Trigeminal nerve injuries may occur from third molar surgery, local anesthetic injections, orthognathic surgery, maxillofacial trauma, implant surgery, pathology surgery or salivary gland surgery, and most often involve the inferior alveolar nerve (IAN), the lingual nerve (LN) and the infraorbital nerve (ION). Evaluation of a patient with a nerve injury begins with the primary complaint, history, a complete examination of the head and neck, including an intraoral examination, clinical neurosensory testing and imaging. The lingual nerve is located and exposed beginning at healthy nerve proximal and distal to the injury site; the lingual nerve is often found in a pouch of fat. The operating surgeon sits on the opposite side from the operation.