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document
The accuracy of clinical neurosensory testing for nerve injury diagnosis . PURPOSE The accuracy of the clinical neurosensory test to diagnose trigeminal nerve injuries has never been statistically evaluated . The purpose of this study was to determine the statistical efficacy of the clinical neurosensory test using surgical findings as the " gold " standard , and to determine whether a correlation existed between the sensory impairment score obtained by preoperative testing and the degree of nerve injury found at surgery . MATERIALS AND METHODS A multisite , randomized , prospective , blinded , clinical trial was conducted on 130 patients with inferior alveolar nerve ( IAN ) and lingual nerve ( LN ) injuries . Preoperatively , patients were provided a sensory impairment score using a three-level drop-out clinical neurosensory test ( NST ) , and blind comparisons were made with the surgical findings postoperatively . RESULTS The positive predictive and negative predictive values for LN-injured patients were 95 % and 100 % , respectively . The positive predictive and negative predictive values for IAN patients were 77 % and 60 % , respectively . There were statistically significant differences in the distribution of age , duration of injury , cause of injury , presence of neuropathic pain , presence of trigger pain , and degree of injury between the IAN and LN patient populations . There was a statistically significant positive relationship found between the sensory impairment score and the degree of nerve injury . CONCLUSIONS The NST is a clinically useful method to diagnose IAN and LN injuries . However , the NST results are less efficient for IAN injuries than LN injuries , and have a high incidence of false-positive ( 23 % ) and false-negative ( 40 % ) results when testing patients with IAN injuries . The different rates of statistical efficiency between the two groups of patients may be attributable to differences in prevalence and biologic covariates .
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Intervention_Physical
clinical neurosensory testing
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Intervention_Physical
clinical neurosensory test
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Intervention_Surgical
patients were provided a sensory impairment score using a three-level drop-out clinical neurosensory test ( NST )
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Intervention_Surgical
blind comparisons were made with the surgical findings postoperatively
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Intervention_Physical
NST
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Outcome_Other
accuracy
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Outcome_Physical
clinical neurosensory testing
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Outcome_Other
statistical efficacy of the clinical neurosensory test
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Outcome_Mental
positive predictive and negative predictive values
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Outcome_Physical
statistically significant positive relationship found between the sensory impairment score and the degree of nerve injury
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Outcome_Other
less efficient
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Outcome_Physical
high incidence of false-positive
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Outcome_Other
false-negative
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Outcome_Other
statistical efficiency
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Participant_Condition
patients with IAN injuries .