are there any (meta) studies on how often nerve damage appears after jaw surgery

[Lazlo]

Good question. I am only 3 months post op so it's relatively early days, but I have this 'altered sensation' thing on one side of my lower lip / chin and personally I am pretty sure this will be permanent. It's hard to explain, but I know my body and it feels like this is here to stay. I am hoping that over time I will get used to it to the extent that I will not be constantly aware of it any more, so that will feel like it's 'improved'. That's what happens with the numbness too, in many cases it never goes away but the person gets used to it so they think it's better.

no, no if you don't have recovery in the first few weeks I'd say it's permanent. But okay, give it like 2 months.

[PloskoPlus]

no, no if you don't have recovery in the first few weeks I'd say it's permanent. But okay, give it like 2 months.

This. When after a few months you're told "wait 9 months, 12 months, 18 months..." it's just your surgeon trying to get rid of you. It may get better, but it's highly unlikely to ever feel normal.

[InvisalignOnly]

I agree with both of you, in most cases these changes are probably permanent. What I see on Facebook is lots of people posting stuff like 'I'm still numb after 4 - 6 - 8 months, when will this go away' and others replying saying it never went away for them. The surgeon will tell you it will go away after several months, but in reality very few people say they were numb for months and then got the feeling back.
The other thing they tell patients to fob them off is when you feel something in the area - the kind of feeling I have - and they say that's a good sign because the nerves are 'waking up'. No your nerves aren't waking up lol - they've been damaged, that's why you have the strange feeling and just be happy if it's not pain or not too disturbing.

[Gadwins]

I highly doubt that and even if there were, there is nothing that can measure how the damage subjectively feels to an individual. This is like migraines: they can be debilitating to the point of making someone effectively disabled, but there is no objective way to measure how 'bad' they are.

As far I understood this method does it: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/nerve-conduction-studies#:~:text=A%20nerve%20conduction%20velocity%20(NCV,patches%20attached%20to%20your%20skin.

So it should be possible to do it on a smaller scale.

Also it is not really bluffing if a surgeon says you should wait 4-8 months, because swelling can also deminish your sensation. I had for example a stagnation in my recovery in the 3rd month, but in the 4th month I got really a boost in my recovery. I would say holding your judgment until the 12th month is a good attitude. After that I would consider as too long for a human being to wait more.

[InvisalignOnly]

It is not really bluffing if a surgeon says you should wait 4-8 months, because swelling can also deminish your sensation. I had for example a stagnation in my recovery in the 3rd month, but in the 4th month I got really a boost in my recovery. I would say holding your judgment until the 12th month is a good attitude. After that I would consider as too long for a human being to wait more.

That's an interesting test; if they tested a few thousand jaw surgery patients like that, I'd be curious to see the results. Re: recovery, obviously there are individual differences, I'm sure some people experience improvement even after several months but that does not seem to be the rule.

Anyway, I did some research and found this study that is interesting to me: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0091055. "The incidences of subjective NSD [neurosensory disturbance] after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively." So according to this, patients have a realistic chance to recover from nerve damage caused by upper jaw surgery, whereas those who reported damage from lower jaw surgery at 6 months post op, seemed to have the same problem 2 years post op (and the rate was roughly one in three patients; 35%). Another interesting sentence from the study: "Although a systematic review showed 12.8% of the patients had persistent NSD [neurosensory disturbance] by objective measurement after an orthognathic surgical procedure, the reported incidences of subjective NSD after orthognathic surgery varied in the literature and could be as high as 87%".

[LeFort 3000]

never damage happens with every surgery. the question is just how close it will heal back to 100%. chances are very high to only gain back 70-90% of before surgery sensation

[kavan]

Okay I understand your point of view now and I can see how what I wrote can be seen as alarmist, but I see it more as realist, even though I should not have written 100% - maybe 99 or 95 or something. Yes you are right, 100% have bone damage lol, but equally 100% also get their nerves messed up to an extent, even if some lucky people recover from that really well and it does not affect their everyday lives on the long run.

The problem with answering questions about 'nerve damage' is that it is quite subjective what we consider 'nerve damage', unless someone gives a clear definition. What I personally meant was that the nerves get messed up, after surgery there is some numbness or altered sensation in - let's say almost - 100% of cases and I personally believe that very few gain their full original feeling back everywhere, specifically after lower jaw surgery and genioplasty. I believe that the majority only end up with a few numb spots that they aren't constantly aware of and it does not cause functional problems; and quite a few end up with a degree of numbness that does affect them (slight problems with speech, not feeling food on the chin etc.), and others end up with constant tingling, pulling, pain or other forms of altered sensation. I know this isn't a scientific study but this is what I've gathered from hearing about people's experiences.

My point is that when you ask doctors about this, they will most likely tell you - presumably based on studies they read - that only a small percentage of people get nerve damage and in almost all cases it takes the form of numbness that the person isn't even aware of. While in practice, it appears that lasting nerve damage, that does affect the person's quality of life, is actually very common - let's say I am wrong and it's not 100 per cent but 'only' 20 per cent, that is still a very high percentage.

Many / most people who had a 'good' outcome, like myself, probably feel that the surgery was still worth it for them even though they suffered a degree of permanent nerve damage. All I am saying is, when people make a decision about whether to get the surgery or not, they should be realistic about the chance of nerve damage rather then thinking oh it's so rare it will never happen to me and even if does it will be nothing etc. For example in my case, I was really sure I would get nerve damage because of my age, so for me it's actually a relief that it is not as bad as I expected. But if someone is a totally normal looking guy to start with, getting surgery to look more masculine or whatever and they think nerve damage will never happen to them, they might end up regretting their decision when it's too late.

Keep in mind my counter commentary was specifically in reference to a claim that '100%' get perm nerve damage. My perspective is that of someone with a highly rigorous scientific background. So, I viewed this as an 'emotional' or subjective assessment and not a scientific one.

Basically, I have no problem with your admonishing people (and think it's a GOOD idea) that they risk permanent altered sensations subsequent to maxfax surgery. Nor do I have any question that studies differ from sample group to sample group or that risks may be under reported or just not universally agreed on... and for those who don't have the wherewithal (basic high school science grounding to know HOW to even look for studies or how to think beyond looking in the mirror and not liking their face).... to those types (which are making up an overwhelming majority of new sign ups), perhaps it IS just a more USEFUL way to discourage them (especially the ones wanting maxfax for 'aesthetics only') that they will all have perm nerve damage afterwards.

[InvisalignOnly]

Keep in mind my counter commentary was specifically in reference to a claim that '100%' get perm nerve damage. My perspective is that of someone with a highly rigorous scientific background. So, I viewed this as an 'emotional' or subjective assessment and not a scientific one.

Oh okay, this is all a misunderstanding then - my bad. I was never meant to say everyone will get permanent nerve damage; I think I was trying to say that everyone's nerves will be severely affected by the surgery, and many (probably the majority) will never recover full original sensation. I obviously expressed that in a stupid way and you're absolutely right to point that out. (I also agree with your points re: some recent new posters but would rather not dwell on that.)

[kavan]

Oh okay, this is all a misunderstanding then - my bad. I was never meant to say everyone will get permanent nerve damage; I think I was trying to say that everyone's nerves will be severely affected by the surgery, and many (probably the majority) will never recover full original sensation. I obviously expressed that in a stupid way and you're absolutely right to point that out. (I also agree with your points re: some recent new posters but would rather not dwell on that.)

OK. All good.