Self-reported Hypoesthesia of the Lower Lip After Sagittal Split Osteotomy

Sagittal split osteotomy may result in sensory impairment of the inferior alveolar nerve; altered sensation in the lower lip varies from patient to patient. We evaluated individual and intraoperative risk factors of sagittal split osteotomy and correlated these findings with self-reported postoperative changes in lower-lip sensation. Follow-up data for 163 consecutive patients who underwent a bilateral sagittal split osteotomy were assessed for self-reported sensibility disturbances in the lower lip at the last follow-up visit. These self-reports were categorized as normal, hypoesthesia, hyperesthesia, or slightly diminished sensation in the central area of the chin. The overall rate of self-reported changed sensibility was 15.1% (49/324; 13.0% on the right side and 17.3% on the left side). Of 16 patients (9.9%) who experienced hypoesthesia on the right side and 25 patients (15.4%) who experienced hypoesthesia on the left side, 10 experienced bilateral hypoesthesia (31 patients total, 19.1%). Genioplasty and age at surgery were significant predictors of hypoesthesia; a 1-year increase in age at surgery increased the odds of hyposensitivity by 5%, and the odds of hypoesthesia in patients with concurrent genioplasty were 4.5 times higher than in patients without genioplasty. Detachment of the nerve at the left side, but not at the right side, was significantly correlated with hypoesthesia.