Nerve graft in microsurgical reconstruction of the lingual nerve

Introduction: Lingual nerve (LN) microsurgical reconstruction is an effective technique with a high success rate. Early surgery is associated with better results. Direct nerve reconstruction and graft reconstruction, whether by allograft or autograft, all present a favorable prognosis. This article presents the treatment protocol in 3 cases of microsurgical reconstruction of the lingual nerve using nerve grafts. Case: The maxillofacial surgery team treated patients from Hospital Dr. Abraham Godoy Peña, Clínica Alemana de Temuco and Hospital Padre Las Casas (Chile). Microsurgical reconstruction by autogenous grafts was performed in 2 cases and allograft in one case; all of them showed positive results (S3+), along with functional sensorial improvemente (FSR+), and recovery of taste. Discussion: LN surgery has been more studied in the last decade. Although many studies with different results exist, early direct reconstruction contributes to better results in FSR. The grafts are reserved for circumstances where the tension doesn't allow a reasonable reconstruction of the LN. The autologous graft has been the gold standard, the sural nerve being the most used. The cost-benefit of using allografts has likewise been widely endorsed. Conclusion: Autolog graft and allograft, in either early or late interventions, have excellent success rates, comparable with direct lingual nerve reconstruction. Further evaluation regarding autologous graft morbidity versus allograft costs is needed.