American Society for Peripheral Nerve

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Post Trigeminal Allograft Repair MRN Analysis
John Randall Zuniga, DMD, MS, PhD
University of Texas Southwestern, Dallas, TX

Introduction: MRN provides good to strong correlation with surgical findings of trigeminal nerve injuries for all Sunderland classifications when preformed in the preoperative/post-injury phase that affects surgical decisions using nerve allografts. MRN may also be used in the post-repair phase when nerve allografts have been used.

Materials and Methods: From 60 patients who underwent MRN for traumatic peripheral trigeminal nerve injuries who underwent surgical repairs with allografts several underwent post-repair MRN to evaluate recurrent pain, failure to progress and/or monitor regeneration. The MRN protocol used 3D imaging including DTI and 3D PSIF. The time from repair to post-repair MRN ranged from 4 to 17 months. MRN was conducted for inferior alveolar and lingual nerves repaired using nerve allografts ranging from 1.5 to 2.0 cm in length x 2 to 4 cm in diameter.

Results: Post-repair MRN demonstrated regeneration of the trigeminal nerve through the allograft in all but one case. In one case, MRN demonstrated a neuroma-in-continuity in the allograft. The findings directly affected surgical and non-surgical decision making in the post-repair phase.

Conclusions: Post-repair MRN provides valuable information about the status of nerve regeneration as well as failure to regenerate through trigeminal nerve allografts in clinical cases

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