--- abstract: "Paresthesia as a result of mechanical trauma is one of the most frequent sensory disturbances of the inferior alveolar nerve. This case report describes surgical treatment for paresthesia caused by a compressive phenomenon within the mandibular canal. The cause of the compression, a broken instrument left in the patient's mouth during previous endodontic therapy, was identified during routine radiography and computed tomography. Once the foreign object was removed by surgery, the paresthesia resolved quickly. This case highlights the potential for an iatrogenic mechanical cause of paresthesia. Comment : The article by Marques and Gomes (J Can Dent Assoc 2011;77:b34) caught my attention. For your information, there is almost an almost similar case reported recently, but with dysesthesia.1 It is fortunate that the patient in the current case has less severe symptoms (occasional numbness of her left lip and a small part of her chin, and a tingling sensation in the vestibular gingival). What I can deduce from the radiographs shown is that the file was actually lodged onto the wall of the periapical defect and the mandibular canal, and because of this the inferior alveolar nerve (IAN) was spared direct injury. Ikeda et al.2 had shown that there is room between the IAN and the canal. However, as reported by the Marques and Gomes, her symptoms were more aggravated in the morning and during stressful situations. This may be a result of fluid accumulation in the morning, or during any sympathetic (stressful) event, that may result in vasodilatation, and hence compression within the narrow mandibular canal that usually average 3.4 + 0.5 mm in diameter. 2,3 I hope this opinion is of help. Thank you." altloc: [] chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: - ngeowy@um.edu.my creators_name: - family: Ngeow given: W.C. honourific: Dr. lineage: '' date: 2011-03-17 date_type: published datestamp: 2012-04-25 13:00:47 department: ~ dir: disk0/00/00/81/71 edit_lock_since: ~ edit_lock_until: 0 edit_lock_user: ~ editors_id: [] editors_name: [] eprint_status: archive eprintid: 8171 fileinfo: application/pdf;http://cogprints.org/8171/1/Decompression%20of%20Inferior%20Alveolar%20Nerve%20Case%20Report%20Comment.pdf full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: ~ item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: A proposal for the mechanism of compression in the mandibular canal by separated endodontic file lastmod: 2012-04-25 13:00:47 latitude: ~ longitude: ~ metadata_visibility: show note: 'Times Cited: 0 Ngeow, W. C.' number: ~ pagerange: ~ pubdom: TRUE publication: Journal of the Canadian Dental Association publisher: 'CANADIAN DENTAL ASSOC, 1815 ALTA VISTA DRIVE, OTTAWA, ON K1G 3Y6, CANADA' refereed: TRUE referencetext: "1. Nayak RN, Hiremath S, Shaikh S, Nayak AR. Dysesthesia with pain due to a broken endodontic instrument lodged in the mandibular canal—a simple deroofing technique for its retrieval: case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111(2):e48-51. \r\n2. Ikeda K, Ho KC, Nowicki BH, Haughton VM. Multiplanar MR and anatomic study of the mandibular canal. AJNR Am J Neuroradiol 1996;17:579-84.\r\n3. Juodzbalys G, Wang HL, Sabalys G. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in relation with Dental Implantology. J Oral Maxillofac Res 2010;1(1):e2" relation_type: [] relation_uri: [] reportno: ~ rev_number: 8 series: ~ source: ~ status_changed: 2012-04-25 13:00:47 subjects: - JOURNALS - OJHAS succeeds: ~ suggestions: "Associate Prof. Dr. Ngeow Wei Cheong @ David Ngeow\r\nDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of\r\nMalaya, 50603 Kuala Lumpur, MALAYSIA\r\n\r\nAssociate Professor Dr. Ngeow Wei Cheong is currently a lecturer at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry of the University of Malaya. He graduated from the University of Malaya in 1992 and was a private practitioner for 9 months before he was offered the post of tutorship at his alma matter. Three years later, he went to do a house job at the Queen Victoria Hospital in East Grinstead, England. He obtained his Fellowship in Dental Surgery from the Royal College of Surgeons in Ireland and the Royal College of Surgeons ofEngland in 1996. He subsequently returned to Malaysia and was a pioneer lecturer at the then newly established Universiti Kebangsaan Malaysia. He left for private practice in 1999 but the temptation to return to academic life was greater, hence he returned to the University of Malaya the subsequent year. His research interest are craniofacial anthropometry, variations of the mandibular nerve, and recovery of peripheral nerves after microsurgical repair. \r\n \r\n\r\nAREAS OF EXPERTISE\r\n\t\r\nDentofacial Anthropometry (Head & Neck, anthropology)\r\n\r\nDental Analgesics (analgesic, local anaesthetic, COX-2 inhibitors)\r\n\r\nSurgical Anatomy (mental foramen, anterior loop)" sword_depositor: ~ sword_slug: ~ thesistype: ~ title: 'Decompression of inferior alveolar nerve: case report comment' type: journalp userid: 16514 volume: 77