Sensory Retraining Following Orthognathic Surgery: Presence of Altered Sensation

Objective: The purpose of this analysis was to compare the presence of altered sensation over a two year period following bilateral sagittal split osteotomy (BSSO) as reported by patients who were given facial sensory retraining exercises in conjunction with standard opening exercises in the first six months after surgery and those who were given standard opening exercises only.

Subjects and Methods: 186 subjects were enrolled in a multi-center double-blind two parallel group stratified block randomized clinical trial. Patient report of the presence of altered sensation was obtained before surgery, 1,3, 6, 12, and 24 months after surgery.

Analysis: A marginal model was fit for the log odds of postoperative altered sensation to examine the effect of sensory retraining while controlling for potential explanatory effects related to demographic, psychological, and clinical factors.

Results: Age (P<0.0001) and the extent of psychological distress (P<0.0001) were significantly associated with the report of altered sensation after controlling for the exercise training received. After controlling for age and psychological distress, patients who received opening exercises only were approximately 2.2 times more likely to report altered sensation compared to patients who received sensory retraining exercises (P<0.03).

Conclusion: The results from this clinical trial support the premise that a simple noninvasive exercise program initiated shortly after orthognathic surgery can lessen the likelihood of a patient reporting altered sensation long term after orthognathic surgery. Supported in part by NIH grant R01-DE013967