A case of nerve repair using a conduit for peripheral nerve regeneration (Nerbridge^®) with lingual nerve injury

Nerve repair refers to the surgical suturing of a divided nerve or using autologous nerve grafting to repair a nerve tissue defect. In April 2016, the nerve conduit Nerbridge® increased treatment options available to persons covered under Japanese dental health insurance as an artificial nerve graft. However, reports of its use for sensory nerve injury in the oral region are scarce. Here we report a case of significant sensory recovery obtained by nerve repair using Nerbridge® in a patient with lingual nerve injury caused by tooth extraction. A 61-year-old woman underwent extraction of an impacted mandibular third molar in February 2016 at a dental clinic. Starting the next day, she complained of hypoesthesia on the right side of the tongue and persistent dysesthesia. That May, she visited our department for in-depth assessment and treatment. We evaluated the patient’s subjective symptoms and imaging findings, and conducted a sensory nerve action potential test to arrive at a diagnosis of partial transection of the right lingual nerve. In October, the patient underwent nerve repair followed by neurorrhaphy, stump excision on both sides, and grafting with Nerbridge® after traumatic neuroma resection under general anesthesia．After the operation using Nerbridge®, the lingual nerve showed marked improvement and recovery as compared with the preoperative sensory function.