Australian Dental Journal
The official journal of the Australian Dental Association
Australian Dental Journal 2015; 60: 412–415 doi: 10.1111/adj.12224
Cerebellopontine angle mass mimicking lingual nerve injury after dental implant placement: a case report Y Momota,* K Kani,* H Takano,* M Azuma* *Department of Oral Medicine, Institute of Health Biosciences, Graduate Faculty of Dentistry, Tokushima University, Japan.
ABSTRACT This is a rare case report of a cerebellopontine angle (CPA) mass mimicking lingual nerve injury after a dental implant placement. Lingual nerve injury is a common complication following dental implant placement. CPA masses are likely to cause symptomatic trigeminal neuralgia, and thus can mimic and be easily confused with oral diseases. We experienced a case of CPA mass mimicking lingual nerve injury after dental implant placement. The patient was a 57-year-old Japanese female who complained of glossalgia. She underwent dental implant placement in the mandible before visiting our clinic. Panoramic x-ray radiography revealed no abnormalities; the salivary flow rate by gum test was 7.0 ml/10 min. She was diagnosed with lingual nerve injury and secondary burning mouth syndrome. Vitamin B12 and oral moisturizer did not provide relief; furthermore, numbness in the lower lip emerged. A Semmes Weinstein test demonstrated elevation of her sensitivity threshold. Finally, magnetic resonance imaging revealed a 20-mm diameter mass in the CPA. The patient is now being followed under conservative management. Our experience underscores the importance of including CPA mass in the differential diagnosis of dental diseases. Keywords: Cerebellopontine angle mass, dental implant placement, lingual nerve injury. Abbreviations and acronyms: BMS = burning mouth syndrome; CN = cranial nerve; CPA = cerebellopontine angle; MRI = magnetic resonance imaging; SW = Semmes Weinstein; TN = trigeminal neuralgia. (Accepted for publication 10 September 2014.)
INTRODUCTION Lingual nerve injury is a common complication following dental procedures such as local anaesthesia and implant placement;1–10 careless management of the lingual flap or epineural haematoma is considered a potential cause of nerve injury.7,10,11 Depending on the degree of the nerve injury, this complication can cause various types of sensory disturbance, including dysaesthesia, paraesthesia, anaesthesia, analgesia, hyperaesthesia, hyperalgesia and allodynia, and is regarded as neuropathic pain in such cases.8–10,12–16 Cerebellopontine angle (CPA) masses occur in the posterior fossa, which is near several roots of the cranial nerves (CN), and are likely to cause symptomatic trigeminal neuralgia (TN).17–23 In addition to TN, CPA masses exhibit a diverse range of clinical features that include headache, dizziness, unstable gait and hemifacial spasm.21,24 Moreover, CPA masses can mimic oral diseases with orofacial pain and thus often bewilder dentists, who often diagnose one of these other diseases before discovering the CPA masses.23,25 412
We experienced a case of CPA mass mimicking lingual nerve injury after dental implant placement. Based on this experience, we discuss the clinical significance of including CPA mass in the differential diagnosis of dental diseases with orofacial pain. CASE REPORT The patient was a 57-year-old Japanese female who visited the Department of Oral Medicine, Tokushima University Hospital, Japan because of glossalgia. The glossalgia, which was localized at the right side of the lingual margin, arose after she underwent an implant placement on the same side of the mandible five months before first visiting our clinic. She was in treatment for hypertension. Intraoral and extraoral examination, including panoramic x-ray radiography, blood examination, culture and salivation test, were performed after taking her medical history, and revealed no neurological abnormalities. Panoramic x-ray radiography revealed no causal relations between the apparent lingual nerve injury and dental implant placement (Fig. 1). In blood examination and culture, no © 2015 Australian Dental Association
Cerebellopontine angle mass with glossalgia
Fig. 1 Panoramic x-ray radiography revealed no causal relations between the lingual nerve injury and dental implant placement.
evidence of potential causative diseases of glossalgia, such as anaemia, xerostomia, or oral candidiasis, was found. A gum test yielded a positive result, with a salivary flow rate of 7.0 ml/10 min (normal range: ≧10 ml/10 min). Neither local analgesic (60–100 mg of 2% lidocaine) nor a non-steroidal anti-inflammatory drug (60 mg of loxoprofen sodium hydrate) was found to relieve the glossalgia. She was given a diagnosis of lingual nerve injury due to implant placement, with secondary burning mouth syndrome (BMS) due to xerostomia. Concomitant administration of vitamin B12 and oral moisturizer had no obvious effects on the glossalgia. Two months after the initiation of this treatment, the patient developed numbness of the lower lip on the same side as the glossalgia. As a neurological examination, the Semmes Weinstein (SW) test was performed and demonstrated an elevated sensitivity threshold at the affected site (Table 1). Finally, she underwent magnetic resonance imaging (MRI) brain scans at the Department of Neurosurgery, Tokushima University Hospital; the gadolinium (Gd)-enhanced MRI T1 weighted image (WI) revealed a 20-mm diameter mass on the same side as the CPA (Fig. 2). She is now being followed closely without therapy to monitor disease progression and symptom intensity at her request. Table 1. Threshold of SW test and 2PD test for lower lip
SW test
2PD test
Point Point Point Point Point Point
11 22 33 44 1 3
Affected side
Healthy side
2.44 3.22 2.44 3.22 12 14
1.65 1.65 1.65 1.65 12 14
SD test, Semmes Weinstein test; 2PD test, two-point discrimination test. 1Lower end of the vermillion border in the lower lip halfway between the philtrum and angulus oris; 2Upper half of the region from point 1 to the lower border of the mandible; 3Lower half of the region from point 1 to the lower border of the mandible; 4 Angulus oris. -The values of the SW test represent filament size; that is, no unit of quantity is required. -The 2PD test values represent mm. © 2015 Australian Dental Association
Fig. 2 Gd-enhanced MRI T1WI revealed a 20-mm diameter mass on the right side of the CPA.
In advance of this study, the procedure was explained to the patient. Her informed consent was then obtained. DISCUSSION To our knowledge, this is a rare case report of a CPA mass mimicking lingual nerve injury after a dental implant placement. Glossalgia is caused by many local, systemic and psychogenic factors;26 glossalgia-related diseases also include oral candidiasis, xerostomia, glossitis, primary BMS and others.27 It is important to screen for other causative factors of glossalgia; medical history taking, intraoral and extraoral examination, x-ray radiography, blood examination, culture and salivation test are all essential procedures.27 In our case, if these procedures had not been performed, we might have diagnosed the patient with primary BMS, i.e. an intraoral burning sensation including glossalgia without medical or dental causes.28 Local analgesic and non-steroidal anti-inflammatory drugs are supposed to act peripherally; in our case, neither treatment had any effect, and thus it was suspected that the glossalgia was not correlate with local problems such as lingual mucous damage but rather with abnormalities somewhere in the CN. Neuropathic pain due to lingual nerve injury can be difficult to diagnose radiographically because of the lack of radiographic abnormalities, and is usually diagnosed after excluding other pathologies that may provoke sensory alterations in the affected area.29 Thus, neurological examinations such as von Frey tactile sensory stimuli and two-point discrimination 413
Y Momota et al. may be useful.7 In our case, even though x-ray radiography revealed no abnormalities (Fig. 1), the SW test, which is a modified von Frey tactile sensory stimuli test, detected sensory abnormalities possibly related to the presence of neurological disorders (Table 1). However, lingual nerve injury cannot be distinguished from CN disorders by neurological examinations alone. CPA masses occur in the posterior fossa, where several CN roots lie, and are associated with symptomatic TN (approximately 0–8% of all TN cases).21,30–32 Furthermore, they can mimic oral diseases with orofacial pain.23 Therefore, it is always difficult for dentists to make an accurate diagnosis of primary BMS, neuropathic pain and symptomatic TN. MRI is very sensitive at identifying CPA masses,25 and capable of demonstrating anatomical landmarks around the trigeminal nerve and CPA.22 In our case, Gd-enhanced MRI T1WI was particularly helpful in showing the CPA mass (Fig. 2). Most CPA masses are acoustic neuroma, trigeminal schwannomas, meningiomas, epidermoid cysts and lipomas.17,18,33 They are benign diseases that tend to remain stable for years (AL Cowan, written communication, June 2004); malignant transformations are reported to be rare.20,24,34 Therefore, conservative management is often selected considering postoperative sequelae in CN dysfunctions even though surgical treatment generally yields excellent results.21 Carbamazepine is often chosen as an initial medical treatment,21 and is successful for most patients, but 30–75% of patients experience side effects or do not experience long-term pain relief.35 Therefore, careful long-term follow-up is required. CONCLUSIONS We experienced a case of CPA mass mimicking lingual nerve injury after dental implant placement. Our experience underscores the importance of screening for organic nervous symptom factors, including the possibility of a CPA mass among the differential diagnoses for glossalgia and other orofacial pain in dental practices. ACKNOWLEDGEMENTS This work was supported by Japan Society for the Promotion of the Science KAKENHI, Grant No. 25463247. REFERENCES 1. Ellies LG. Altered sensation following mandibular implant surgery: a retrospective study. J Prosthet Dent 1992;68:664–667. 2. Ellies LG, Hawker PB. The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants 1993;8:674–679.
414
3. Pogral MA, Kaban LB. Injuries to the inferior alveolar and lingual nerves. J Calif Dent Assoc 1993;21:50–54. 4. Pogral MA, Thamby S. The etiology of altered sensation in the inferior alveolar, lingual and mental nerves as a result of dental treatment. J Calif Dent Assoc 1999;27:531–538. 5. Holzle FW. Anatomic position of the lingual nerve in the mandibular third molar region with special consideration of an atrophied mandibular crest: an anatomical study. Int J Oral Maxillofac Surg 2001;30:333–338. 6. Robinson PP, Loescher AR, Smith KG. A prospective, quantitative study on the clinical outcome of lingual nerve repair. Br J Oral Maxillofac Surg 2001;38:255–263. 7. Graff-Radford SB, Evans RW. Lingual nerve injury. Headache 2003;43:975–983. 8. Rasmussen RV, Sindrup SH, Jensen TS, Bach FW. Symptoms and signs in patients with suspected neuropathic pain. Pain 2004;110:461–469. 9. Lewis MA, Sankar V, De Laat A, Benoliel R. Management of neuropathic orofacial pain. OOOOE 2007;103(Suppl):e1– 24. 10. Alhassani AA, AlGhamdi AS. Inferior alveolar nerve injury in implant dentistry: diagnosis, causes, prevention, and management. J Oral Implantol 2010;36:401–407. 11. Chan HL, Leong DJM, Fu JH, Yeh CY, Tatarakis N, Wang HL. The significance of the lingual nerve during periodontal/ implant surgery. J Periodontol 2010;81:372–377. 12. Kipp DP, Goldstein BH, Weiss Jr WW. Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1377 surgical procedures. J Am Dent Assoc 1980;100:185– 192. 13. LaBanc JP. Trigeminal nerve injury: diagnosis and management. Oral Maxillofac Clin North Am 1992;4:285–296. 14. Zuniga JR, Essick GK. A contemporary approach to the clinical evaluation of trigeminal nerve injuries. Oral Maxillofac Clin North Am 1992;4:353–367. 15. Vickers ER, Cousins MJ. Neuropathic orofacial pain. Part 1: prevalence and pathophysiology. Aust Endod J 2000;26:19– 26. 16. Fukuda K, Ichinohe T, Kaneko Y. Pain management for nerve injury following dental implant surgery at Tokyo Dental College Hospital. Int J Dent 2012;2012:209474. 17. Bullitt E, Tew JM. Intracranial tumors in patients with facial pain. J Neurosurg 1986;64:865–871. 18. Iwasaki K, Kondo A, Otsuka S, Hasegawa K, Ohbayashi T. Painful tic convulsif caused by a brain tumor: case report and review of the literature. Neurosurgery 1992;30:916–919. 19. Cheng TM, Cascino TL, Onofrio BM. Comprehensive study of diagnosis and treatment of trigeminal neuralgia secondary to tumors. Neurology 1993;43:2298–2302. 20. Desai K, Nadkarni T, Bhayani R, Goel A. Cerebellopontine angle epidermoid tumor presenting with hemifacial spasms. Neurol India 2003;51:288–289. 21. Cirak B, Kiymaz N, Arslanoglu A. Trigeminal neuralgia caused by intracranial epidermoid tumor: report of a case and review of the different therapeutic modalities. Pain Physician 2004;7: 129–132. 22. Scrivani S, Mathews E, Maciewicz R. Trigeminal neuralgia. OOOOE 2005;100:527–538. 23. Klieb HBE, Freeman BV. Trigeminal neuralgia caused by intracranial epidermoid tumour: report of a case. JCDA 2008;74: 63–65. 24. Fujita N, Hirabuki N, Kashiwagi N, Watanabe Y, Nakamura H. Epidermoid tumor of the cerebellopontine angle: signal loss in the contralateral cistern. AJNR Am J Neuroradiol 1998;19: 333–335. © 2015 Australian Dental Association
Cerebellopontine angle mass with glossalgia 25. Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ 2014;348:g474. 26. Scala A, Checchi L, Montevecchi M, Marini I. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 2003;14:275–291. 27. Momota Y, Takano H, Kani K, et al. Clinical statistics of patients with lingual abnormalities including glossalgia – clinical characteristics of glossodynia. Jpn J Orofac Pain 2012;5:27–35. 28. International Headache Society. The International Classification of Headache Disorders. 2nd edn. Cephalalgia 2004;24(Suppl 1):9–160. 29. Rodrıguez-Lozano FJ, Sanchez-Perez A, Moya-Villaescusa MJ, Rodrıguez-Lozano A, Saez-Yuguero MR. Neuropathic orofacial pain after dental implant placement: review of the literature and case report. OOOOE 2010;109:e8–e12. 30. Apfelbaum RI. Surgery for tic douloureux. Clin Neurosurg 1983;31:351–368. 31. Bederson JB, Wilson CB. Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. Neurosurg 1989;1:359–367.
© 2015 Australian Dental Association
32. Aksik I. Microneural decompression operations in the treatment of some forms of cranial rhizopathy. Acta Neurochir (Wien) 1993;125:64–74. 33. Khan J, Heir GM, Quek SYP. Cerebellopontine angle (CPA) tumor mimicking dental pain following facial trauma. J Craniomand Pract 2010;28:205–208. 34. Nishiura I, Koyama T, Handa J, Amano S. Primary intracranial epidermoid carcinoma–case report. Neurol Med Chir (Tokyo) 1989;29:600–605. 35. Taylor JC, Brauer S, Espir ML. Long-term treatment of trigeminal neuralgia with carbamazepine. Postgrad Med J 1981;57:16– 18.
Address for correspondence: Dr Yukihiro Momota, DDS, PhD Kuramoto 3-18-15 Tokushima 770-8504 Japan Email: [email protected]
415
The official journal of the Australian Dental Association
Australian Dental Journal 2015; 60: 412–415 doi: 10.1111/adj.12224
Cerebellopontine angle mass mimicking lingual nerve injury after dental implant placement: a case report Y Momota,* K Kani,* H Takano,* M Azuma* *Department of Oral Medicine, Institute of Health Biosciences, Graduate Faculty of Dentistry, Tokushima University, Japan.
ABSTRACT This is a rare case report of a cerebellopontine angle (CPA) mass mimicking lingual nerve injury after a dental implant placement. Lingual nerve injury is a common complication following dental implant placement. CPA masses are likely to cause symptomatic trigeminal neuralgia, and thus can mimic and be easily confused with oral diseases. We experienced a case of CPA mass mimicking lingual nerve injury after dental implant placement. The patient was a 57-year-old Japanese female who complained of glossalgia. She underwent dental implant placement in the mandible before visiting our clinic. Panoramic x-ray radiography revealed no abnormalities; the salivary flow rate by gum test was 7.0 ml/10 min. She was diagnosed with lingual nerve injury and secondary burning mouth syndrome. Vitamin B12 and oral moisturizer did not provide relief; furthermore, numbness in the lower lip emerged. A Semmes Weinstein test demonstrated elevation of her sensitivity threshold. Finally, magnetic resonance imaging revealed a 20-mm diameter mass in the CPA. The patient is now being followed under conservative management. Our experience underscores the importance of including CPA mass in the differential diagnosis of dental diseases. Keywords: Cerebellopontine angle mass, dental implant placement, lingual nerve injury. Abbreviations and acronyms: BMS = burning mouth syndrome; CN = cranial nerve; CPA = cerebellopontine angle; MRI = magnetic resonance imaging; SW = Semmes Weinstein; TN = trigeminal neuralgia. (Accepted for publication 10 September 2014.)
INTRODUCTION Lingual nerve injury is a common complication following dental procedures such as local anaesthesia and implant placement;1–10 careless management of the lingual flap or epineural haematoma is considered a potential cause of nerve injury.7,10,11 Depending on the degree of the nerve injury, this complication can cause various types of sensory disturbance, including dysaesthesia, paraesthesia, anaesthesia, analgesia, hyperaesthesia, hyperalgesia and allodynia, and is regarded as neuropathic pain in such cases.8–10,12–16 Cerebellopontine angle (CPA) masses occur in the posterior fossa, which is near several roots of the cranial nerves (CN), and are likely to cause symptomatic trigeminal neuralgia (TN).17–23 In addition to TN, CPA masses exhibit a diverse range of clinical features that include headache, dizziness, unstable gait and hemifacial spasm.21,24 Moreover, CPA masses can mimic oral diseases with orofacial pain and thus often bewilder dentists, who often diagnose one of these other diseases before discovering the CPA masses.23,25 412
We experienced a case of CPA mass mimicking lingual nerve injury after dental implant placement. Based on this experience, we discuss the clinical significance of including CPA mass in the differential diagnosis of dental diseases with orofacial pain. CASE REPORT The patient was a 57-year-old Japanese female who visited the Department of Oral Medicine, Tokushima University Hospital, Japan because of glossalgia. The glossalgia, which was localized at the right side of the lingual margin, arose after she underwent an implant placement on the same side of the mandible five months before first visiting our clinic. She was in treatment for hypertension. Intraoral and extraoral examination, including panoramic x-ray radiography, blood examination, culture and salivation test, were performed after taking her medical history, and revealed no neurological abnormalities. Panoramic x-ray radiography revealed no causal relations between the apparent lingual nerve injury and dental implant placement (Fig. 1). In blood examination and culture, no © 2015 Australian Dental Association
Cerebellopontine angle mass with glossalgia
Fig. 1 Panoramic x-ray radiography revealed no causal relations between the lingual nerve injury and dental implant placement.
evidence of potential causative diseases of glossalgia, such as anaemia, xerostomia, or oral candidiasis, was found. A gum test yielded a positive result, with a salivary flow rate of 7.0 ml/10 min (normal range: ≧10 ml/10 min). Neither local analgesic (60–100 mg of 2% lidocaine) nor a non-steroidal anti-inflammatory drug (60 mg of loxoprofen sodium hydrate) was found to relieve the glossalgia. She was given a diagnosis of lingual nerve injury due to implant placement, with secondary burning mouth syndrome (BMS) due to xerostomia. Concomitant administration of vitamin B12 and oral moisturizer had no obvious effects on the glossalgia. Two months after the initiation of this treatment, the patient developed numbness of the lower lip on the same side as the glossalgia. As a neurological examination, the Semmes Weinstein (SW) test was performed and demonstrated an elevated sensitivity threshold at the affected site (Table 1). Finally, she underwent magnetic resonance imaging (MRI) brain scans at the Department of Neurosurgery, Tokushima University Hospital; the gadolinium (Gd)-enhanced MRI T1 weighted image (WI) revealed a 20-mm diameter mass on the same side as the CPA (Fig. 2). She is now being followed closely without therapy to monitor disease progression and symptom intensity at her request. Table 1. Threshold of SW test and 2PD test for lower lip
SW test
2PD test
Point Point Point Point Point Point
11 22 33 44 1 3
Affected side
Healthy side
2.44 3.22 2.44 3.22 12 14
1.65 1.65 1.65 1.65 12 14
SD test, Semmes Weinstein test; 2PD test, two-point discrimination test. 1Lower end of the vermillion border in the lower lip halfway between the philtrum and angulus oris; 2Upper half of the region from point 1 to the lower border of the mandible; 3Lower half of the region from point 1 to the lower border of the mandible; 4 Angulus oris. -The values of the SW test represent filament size; that is, no unit of quantity is required. -The 2PD test values represent mm. © 2015 Australian Dental Association
Fig. 2 Gd-enhanced MRI T1WI revealed a 20-mm diameter mass on the right side of the CPA.
In advance of this study, the procedure was explained to the patient. Her informed consent was then obtained. DISCUSSION To our knowledge, this is a rare case report of a CPA mass mimicking lingual nerve injury after a dental implant placement. Glossalgia is caused by many local, systemic and psychogenic factors;26 glossalgia-related diseases also include oral candidiasis, xerostomia, glossitis, primary BMS and others.27 It is important to screen for other causative factors of glossalgia; medical history taking, intraoral and extraoral examination, x-ray radiography, blood examination, culture and salivation test are all essential procedures.27 In our case, if these procedures had not been performed, we might have diagnosed the patient with primary BMS, i.e. an intraoral burning sensation including glossalgia without medical or dental causes.28 Local analgesic and non-steroidal anti-inflammatory drugs are supposed to act peripherally; in our case, neither treatment had any effect, and thus it was suspected that the glossalgia was not correlate with local problems such as lingual mucous damage but rather with abnormalities somewhere in the CN. Neuropathic pain due to lingual nerve injury can be difficult to diagnose radiographically because of the lack of radiographic abnormalities, and is usually diagnosed after excluding other pathologies that may provoke sensory alterations in the affected area.29 Thus, neurological examinations such as von Frey tactile sensory stimuli and two-point discrimination 413
Y Momota et al. may be useful.7 In our case, even though x-ray radiography revealed no abnormalities (Fig. 1), the SW test, which is a modified von Frey tactile sensory stimuli test, detected sensory abnormalities possibly related to the presence of neurological disorders (Table 1). However, lingual nerve injury cannot be distinguished from CN disorders by neurological examinations alone. CPA masses occur in the posterior fossa, where several CN roots lie, and are associated with symptomatic TN (approximately 0–8% of all TN cases).21,30–32 Furthermore, they can mimic oral diseases with orofacial pain.23 Therefore, it is always difficult for dentists to make an accurate diagnosis of primary BMS, neuropathic pain and symptomatic TN. MRI is very sensitive at identifying CPA masses,25 and capable of demonstrating anatomical landmarks around the trigeminal nerve and CPA.22 In our case, Gd-enhanced MRI T1WI was particularly helpful in showing the CPA mass (Fig. 2). Most CPA masses are acoustic neuroma, trigeminal schwannomas, meningiomas, epidermoid cysts and lipomas.17,18,33 They are benign diseases that tend to remain stable for years (AL Cowan, written communication, June 2004); malignant transformations are reported to be rare.20,24,34 Therefore, conservative management is often selected considering postoperative sequelae in CN dysfunctions even though surgical treatment generally yields excellent results.21 Carbamazepine is often chosen as an initial medical treatment,21 and is successful for most patients, but 30–75% of patients experience side effects or do not experience long-term pain relief.35 Therefore, careful long-term follow-up is required. CONCLUSIONS We experienced a case of CPA mass mimicking lingual nerve injury after dental implant placement. Our experience underscores the importance of screening for organic nervous symptom factors, including the possibility of a CPA mass among the differential diagnoses for glossalgia and other orofacial pain in dental practices. ACKNOWLEDGEMENTS This work was supported by Japan Society for the Promotion of the Science KAKENHI, Grant No. 25463247. REFERENCES 1. Ellies LG. Altered sensation following mandibular implant surgery: a retrospective study. J Prosthet Dent 1992;68:664–667. 2. Ellies LG, Hawker PB. The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants 1993;8:674–679.
414
3. Pogral MA, Kaban LB. Injuries to the inferior alveolar and lingual nerves. J Calif Dent Assoc 1993;21:50–54. 4. Pogral MA, Thamby S. The etiology of altered sensation in the inferior alveolar, lingual and mental nerves as a result of dental treatment. J Calif Dent Assoc 1999;27:531–538. 5. Holzle FW. Anatomic position of the lingual nerve in the mandibular third molar region with special consideration of an atrophied mandibular crest: an anatomical study. Int J Oral Maxillofac Surg 2001;30:333–338. 6. Robinson PP, Loescher AR, Smith KG. A prospective, quantitative study on the clinical outcome of lingual nerve repair. Br J Oral Maxillofac Surg 2001;38:255–263. 7. Graff-Radford SB, Evans RW. Lingual nerve injury. Headache 2003;43:975–983. 8. Rasmussen RV, Sindrup SH, Jensen TS, Bach FW. Symptoms and signs in patients with suspected neuropathic pain. Pain 2004;110:461–469. 9. Lewis MA, Sankar V, De Laat A, Benoliel R. Management of neuropathic orofacial pain. OOOOE 2007;103(Suppl):e1– 24. 10. Alhassani AA, AlGhamdi AS. Inferior alveolar nerve injury in implant dentistry: diagnosis, causes, prevention, and management. J Oral Implantol 2010;36:401–407. 11. Chan HL, Leong DJM, Fu JH, Yeh CY, Tatarakis N, Wang HL. The significance of the lingual nerve during periodontal/ implant surgery. J Periodontol 2010;81:372–377. 12. Kipp DP, Goldstein BH, Weiss Jr WW. Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1377 surgical procedures. J Am Dent Assoc 1980;100:185– 192. 13. LaBanc JP. Trigeminal nerve injury: diagnosis and management. Oral Maxillofac Clin North Am 1992;4:285–296. 14. Zuniga JR, Essick GK. A contemporary approach to the clinical evaluation of trigeminal nerve injuries. Oral Maxillofac Clin North Am 1992;4:353–367. 15. Vickers ER, Cousins MJ. Neuropathic orofacial pain. Part 1: prevalence and pathophysiology. Aust Endod J 2000;26:19– 26. 16. Fukuda K, Ichinohe T, Kaneko Y. Pain management for nerve injury following dental implant surgery at Tokyo Dental College Hospital. Int J Dent 2012;2012:209474. 17. Bullitt E, Tew JM. Intracranial tumors in patients with facial pain. J Neurosurg 1986;64:865–871. 18. Iwasaki K, Kondo A, Otsuka S, Hasegawa K, Ohbayashi T. Painful tic convulsif caused by a brain tumor: case report and review of the literature. Neurosurgery 1992;30:916–919. 19. Cheng TM, Cascino TL, Onofrio BM. Comprehensive study of diagnosis and treatment of trigeminal neuralgia secondary to tumors. Neurology 1993;43:2298–2302. 20. Desai K, Nadkarni T, Bhayani R, Goel A. Cerebellopontine angle epidermoid tumor presenting with hemifacial spasms. Neurol India 2003;51:288–289. 21. Cirak B, Kiymaz N, Arslanoglu A. Trigeminal neuralgia caused by intracranial epidermoid tumor: report of a case and review of the different therapeutic modalities. Pain Physician 2004;7: 129–132. 22. Scrivani S, Mathews E, Maciewicz R. Trigeminal neuralgia. OOOOE 2005;100:527–538. 23. Klieb HBE, Freeman BV. Trigeminal neuralgia caused by intracranial epidermoid tumour: report of a case. JCDA 2008;74: 63–65. 24. Fujita N, Hirabuki N, Kashiwagi N, Watanabe Y, Nakamura H. Epidermoid tumor of the cerebellopontine angle: signal loss in the contralateral cistern. AJNR Am J Neuroradiol 1998;19: 333–335. © 2015 Australian Dental Association
Cerebellopontine angle mass with glossalgia 25. Zakrzewska JM, Linskey ME. Trigeminal neuralgia. BMJ 2014;348:g474. 26. Scala A, Checchi L, Montevecchi M, Marini I. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med 2003;14:275–291. 27. Momota Y, Takano H, Kani K, et al. Clinical statistics of patients with lingual abnormalities including glossalgia – clinical characteristics of glossodynia. Jpn J Orofac Pain 2012;5:27–35. 28. International Headache Society. The International Classification of Headache Disorders. 2nd edn. Cephalalgia 2004;24(Suppl 1):9–160. 29. Rodrıguez-Lozano FJ, Sanchez-Perez A, Moya-Villaescusa MJ, Rodrıguez-Lozano A, Saez-Yuguero MR. Neuropathic orofacial pain after dental implant placement: review of the literature and case report. OOOOE 2010;109:e8–e12. 30. Apfelbaum RI. Surgery for tic douloureux. Clin Neurosurg 1983;31:351–368. 31. Bederson JB, Wilson CB. Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. Neurosurg 1989;1:359–367.
© 2015 Australian Dental Association
32. Aksik I. Microneural decompression operations in the treatment of some forms of cranial rhizopathy. Acta Neurochir (Wien) 1993;125:64–74. 33. Khan J, Heir GM, Quek SYP. Cerebellopontine angle (CPA) tumor mimicking dental pain following facial trauma. J Craniomand Pract 2010;28:205–208. 34. Nishiura I, Koyama T, Handa J, Amano S. Primary intracranial epidermoid carcinoma–case report. Neurol Med Chir (Tokyo) 1989;29:600–605. 35. Taylor JC, Brauer S, Espir ML. Long-term treatment of trigeminal neuralgia with carbamazepine. Postgrad Med J 1981;57:16– 18.
Address for correspondence: Dr Yukihiro Momota, DDS, PhD Kuramoto 3-18-15 Tokushima 770-8504 Japan Email: [email protected]
415
