하치조신경(inferior alveolar nerve)은 삼차신경(trigeminal nerve)의 종말가지 중 하나로, 하악지 내측에서 하악공(mandibular foramen)을 통해 하악골의 내부로 들어가서 하악관(mandibular canal)을 따라 주행하는 감각 신경이다. 최근들어 임플란트 치료와 악교정 수술이 빈번해지면서, 이와 관련된 하치조신경 손상이 증가하 고 있다1). 하치조신경감각검사는 자극에 대한 반응을 해석하는 객관적 검사 와 환자의 진술에 따라 손상 정도를 가늠하는 주관적 평가로 대별된 다. 널리 사용되고 있는 검사 방법에는 접촉역치검사, 이점식별능검 사, 방향인지능검사, 통각검사, 온도 자극 검사, 압감/통감 구분 검사 등이 있으며, 그 외에도 여러 기계적인 측정 방법이 추가적으로 시도 되고 있다. 하지만, 아직까지 표준화된 임상 검사 방법이 확립되어 있지 않은 실정이다. 이는 대부분의 임상검사
Purpose: Many clinical tests have been developed since 1988, when Mackinnon and Dellon used a modified British Medical Research Council scale to grade injury and monitor sensory recovery following trigeminal nerve injuries. Yet little attention has been focused on standard clinical test for the diagnosis of inferior alveolar nerve damage. Recently, Jääskeläinen suggested the mental nerve blink reflex test as a new diagnostic tool for quantifying the degree of inferior alveolar nerve damage. In this study, the mental nerve blink reflex test was performed on the Korean population for the first time, and its effectiveness and clinical relevancy were confirmed. Materials and Methods: This study mainly comprised of two experimental groups. In the first group, the mental nerve blink reflex test was performed on patients who underwent partial mandibulectomy for the treatment of squamous cell carcinoma involving the inferior alveolar nerve. The normal mental nerve blink reflex response was evaluated in the second group which consisted of 20 healthy volunteers, including 10 women and 10 men, without any neurological diseases. The mean age of the group was 29.5 years, ranging from 26 to 32 years. Neuro-EMG-micro (NeurosoftTM, Ivanovo, Russia) was used to measure the threshold current, delayed time, duration, and amplitude of mental nerve blink reflex response, and Neuro-MEPω (NeurosoftTM, Ivanovo, Russia) program was used to analyze the data. Results: The first experimental group showed loss of mental nerve blink reflex after the surgery. In the second group, average values of 13 mA (standard deviation [SD]±8.68), 42.36 ms (SD±7.58), 38.85 ms (SD±12.41), and 198.65 mA (SD±116.08) were recorded for threshold current, delayed time, duration, and amplitude, respectively. Conclusions: The mental nerve blink reflex test was able to clearly distinguish between anesthesia and normal blink reflex response. Upon analysis of normal response, only the delayed time showed statistical significance and possible relevance to the nerve injuries. (JOURNAL OF DENTAL IMPLANT RESEARCH 2014;33(1):7-11)
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