nerve deficits can reduce patient life satisfaction by 28%1

Nerve repair during mandibular resection can help save patients a lifetime of struggle with sensation loss.2,3

without nerve reconstruction, patients lose more than sensation

A nerve deficit means turning down social invitations because eating in public brings constant worry that they won’t feel food stuck on their face. It’s struggling to nail a job interview because their speech doesn’t sound normal. It’s not being able to feel a kiss or a growing smile. Or worse, it’s pain.

  • 70% of patients with dental or lingual nerve injuries reported struggling to enjoy socializing daily.4
  • 60% of patients with dental or lingual nerve injuries reported struggling to eat multiple times a week (n=30).4
  • Patients with lingual or inferior alveolar nerve deficits reported 28% lower life satisfaction than those without.1
  • Patients who underwent immediate nerve reconstruction had a 43% lower chance of experiencing chronic post-surgical pain or post-traumatic trigeminal neuropathic pain than those who did not undergo nerve reconstruction.5

There’s a path to potentially improve feeling and function for your mandibular resection patients.

A line illustration of the nerves in the head and neck

Surgeon perspective:

How does restoring sensation impact patients?

For patients who underwent nerve reconstruction, they’re very happy when they get sensation back. When that sensation starts to return, it’s all they talk about.

— PATRICK B. GARVEY, MD, FACS

Dr. Patrick Garvey looks at the interviewer in a still photo from a video interview Play button

nerve reconstruction is
possible—and accessible

We get it. Nerve function isn’t always on the priority list in a complex procedure like mandible resection. But with a few minutes of advance planning paired with your microsurgical skills, reconstructing the nerve can fit into your surgical plan with minimal disruption.

A cross-section rendering shows a reconstructed mandible

a matter of millimeters. a lifetime of sensation.

A minimal addition to your procedure can help save patients from permanent nerve deficits, lost function and chronic pain.3,5,6

A young woman holds a popsicle stick to her lips

positively impacts patients’ lives

Surgeons report that patients’ demeanor and outlook on life noticeably improves when sensation returns.7

Rendering of a nerve repair in progress

adds minimal surgical time

With advance planning, sensory restoration can be integrated into the surgical plan with minimal additional time once it becomes part of the routine.

A person undergoes radiation therapy

can be performed in patients undergoing radiation

Postoperative treatment with radiation therapy does not impact nerve sensory recovery.6

Surgeon perspective:

Reconstructing a resected nerve to help patients avoid a potential lifetime of nerve-related symptoms

If we resect a nerve and don’t reconstruct it, there are neuromas or scars that can form on each of the nerve stumps. And those neuromas can be painful; they can cause numbness. They can cause burning and a variety of other painful symptoms, and these patients would have to endure that for the rest of their lives.

— MICHAEL MILORO, DMD, MD, FACS

Dr. Michael Miloro looks at the camera in a still photo from a video interview Play button

Surgeon perspective:

Why restore sensation?

You have the ability to potentially give this person back sensation with a minimal amount of your time. It changes that person’s life forever.

— JAMES C. MELVILLE, MD, FACS

Dr. James Melville smiles and gestures in a still photo from a video interview Play button

feeling is function. it's yours to restore.

Nerve reconstruction has the potential to restore pre-surgical levels of sensation3—helping patients regain lost function.

89%

Nearly 90% of study participants (n=18) who underwent inferior alveolar nerve (IAN) reconstruction achieved functional sensory recovery within one year.3

read study

6x

Study patients who underwent nerve repair were 6x less likely to experience chronic post-surgical pain.5

read study

6 months

Six months after IAN reconstruction, all study participants (n=18) who underwent mandibular surgery and reconstruction with processed nerve allograft repair reported no unpleasantness from altered sensations.3

read study

PUBLICATIONS

Full Axogen clinical bibliography

A case-and-control, multisite, positive controlled, prospective study of the safety and effectiveness of Immediate Inferior alveolar nerve processed nerve allograft reconstruction with ablation of the mandible for benign pathology

Does immediate long-span nerve allograft reconstruction affect the incidence of chronic postsurgical and neuropathic pain in the reconstructed mandible following resection for benign and malignant disease

Neurosensory Reconstruction of the Mandible: Technical Aspects

Trigeminal neurosensory deficit and patient reported outcome measures: the effect on quality of life

RESOURCES

Reimbursement guide and coding assistance

Research: IAN deficits can significantly diminish patients’ quality of life

Brochure: IAN reconstruction

IAN reconstruction in a segmental mandible resection via mandibular foramen access

IAN reconstruction in a segmental mandible resection via buccal decortication access

SOLUTIONS

Product image of Avance Nerve Graft Avance Nerve Graft® Product image of Axoguard® Nerve Connector Axoguard Nerve Connector® Product image of Axoguard® Nerve Protector Axoguard Nerve Protector® Product image of Avive+ Soft Tissue Matrix Axoguard HA+ Nerve Protector™

See sizing and IFU on solution pages.

discover a viable repair solution

Avance Nerve Graft empowers you to help restore feeling and function for your patients.

With no donor site comorbidities or time requirement to harvest an autograft nerve, allograft has proven to be an efficient standard of care.8-10

see the data

Text reads “See new possibilities in nerve repair for your patients” over a background of a medical illustration

video resources

Preview of a video, “Mandible nerve repair: why do it?” from the series, “Bridging the Gap: Clinicians Talk Nerve Repair”
Mandibular nerve reconstruction in malignancy with Dr. Patrick Garvey
Preview of a video, “Sensory reinnervation: AAOMS parameters of care” from the series, “Bridging the Gap: Clinicians Talk Nerve Repair”
Minimizing time for repairing the nerve in ablative mandibular reconstruction with Michael Miloro, DMD, MD, FACS
Preview of a video, “Mandibular nerve reconstruction in malignancy” from the series “Bridging the Gap: Clinicians Talk Nerve Repair”
Impact on patients with Dr. Patrick Garvey
Preview of a video, “Minimizing the time for repairing the nerve in ablative mandibular reconstruction” from the series “Bridging the Gap: Clinicians Talk Nerve Repair”
Reconstructing a resected nerve with Michael Miloro, DMD, MD, FACS
Preview of a video, “Reconstructing the nerve: helping to restore normalcy” from the series “Bridging the Gap: Clinicians Talk Nerve Repair”
Why restore sensation? with James C. Melville, MD, FACS
connect with a nerve rep

There’s only a short form between you and our nerve product team who can help you get more information about our nerve repair solutions.

contact

references

  1. Leung YY, et al. Trigeminal neurosensory deficit and patient reported outcome measures: the effect on life satisfaction and depression symptoms. PLoS One. 2013;8(8):e72891. Published 2013 Aug 29. doi:10.1371/journal.pone.0072891
  2. Zuniga JR. Sensory outcomes after reconstruction of lingual and inferior alveolar nerve discontinuities using processed nerve allograft–a case series. J Oral Maxillofac Surg. 2015;73(4):734-744. doi:10.1016/j.joms.2014.10.030
  3. Zuniga JR, et al. A case-and-control, multisite, positive controlled, prospective study of the safety and effectiveness of immediate inferior alveolar nerve processed nerve allograft reconstruction with ablation of the mandible for benign pathology. J Oral Maxillofac Surg. 2017;75(12):2669-2681. doi:10.1016/j.joms.2017.04.002
  4. Patel N, et al. Quality of life following injury to the inferior dental or lingual nerve – a cross-sectional mixed-methods study. Oral Surg. 2018;11:9-16. https://doi.org/10.1111/ors.12259
  5. Zuniga JR, et al. Does immediate long-span nerve allograft reconstruction affect the incidence of chronic postsurgical and neuropathic pain in the reconstructed mandible following resection for benign and malignant disease. J Oral Maxillofac Surg. 2023;81(12):1587-1593. doi:10.1016/j.joms.2023.09.00
  6. Kaplan J, et al. Sensory outcomes for inferior alveolar nerve reconstruction with allograft following free fibula mandible reconstruction. Plast Reconstr Surg. 2023;152(3):499e-506e. doi:10.1097/PRS.0000000000010286
  7. Axogen data on file.
  8. Lans J, et al. A systematic review and meta-analysis of nerve gap repair: comparative effectiveness of allografts, autografts, and conduits. Plast Reconstr Surg. 2023 May 1;151(5):814e-827e. doi: 10.1097/PRS.0000000000010088.
  9. Raizman NM, et al. Procedure costs of peripheral nerve graft reconstruction. Plast Reconstr Surg Glob Open. 2023;11(4):e4908. Published 2023 Apr 10. doi:10.1097/GOX.0000000000004908
  10. Safa B, Momeni A. Reconsidering the standard of care for peripheral nerve reconstruction. Plast Reconstr Surg Glob Open. 2023;11(11):e5320. Published 2023 Nov 16. doi:10.1097/GOX.0000000000005320