Managing iatrogenic trigeminal nerve injury: a case series and review of the literature

Int J Oral Maxillofac Surg. 2012 May;41(5):629-37. doi: 10.1016/j.ijom.2011.11.002. Epub 2012 Feb 10.


This study describes the management of 216 patients with post-traumatic iatrogenic lingual nerve injuries (LNIs; n=93) and inferior alveolar nerve injuries (IANI; n=123). At initial consultation, 6% IANI and 2% LNI patients had undergone significant resolution requiring no further reviews. Reassurance and counselling was adequate management for 51% IANI and 55% LNI patients. Systemic or topical medication was offered as pain relief to 5% of patients. Additional cognitive behaviour therapy (CBT) was offered to 8% of patients. Topical 5% lidocaine patches reduced pain and allodynia in 7% of IANI patients, most often used without any other form of management. A small percentage of IANI patients (4%) received a combination of therapies involving CBT, surgery, medication and 5% lidocaine patches. Exploratory surgery improved symptoms and reduced neuropathic area in 18 LNI and 15 IANI patients resulting in improved quality of life. In conclusion, the authors suggest a more diverse and perhaps holistic strategy for management of patients with iatrogenic trigeminal nerve injuries and recommend pragmatic assessment criteria for measurement of treatment success in these patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use
  • Anastomosis, Surgical / methods
  • Anesthetics, Local / administration & dosage
  • Cognitive Behavioral Therapy
  • Cohort Studies
  • Combined Modality Therapy
  • Counseling
  • Decompression, Surgical / methods
  • Humans
  • Iatrogenic Disease*
  • Lidocaine / administration & dosage
  • Lingual Nerve Injuries / therapy
  • Mandibular Nerve / pathology
  • Middle Aged
  • Pain Management / methods
  • Pain Measurement
  • Quality of Life
  • Remission, Spontaneous
  • Somatosensory Disorders / classification
  • Somatosensory Disorders / diagnosis
  • Trigeminal Nerve Injuries / diagnosis
  • Trigeminal Nerve Injuries / therapy*
  • Trigeminal Neuralgia / diagnosis
  • Trigeminal Neuralgia / therapy
  • Young Adult


  • Analgesics
  • Anesthetics, Local
  • Lidocaine