The effect of nasal septum surgery on anterior maxillary teeth sensation - a prospective study.

Introduction: Nasal septum surgery has been associated with postoperative numbness or paresthesia of the anterior maxillary teeth, primarily involving the incisors and canines, with an incidence reported between 3% and 30%. This sensory alteration may result from trauma to the nasopalatine nerve or anterior superior alveolar nerve, which innervate the anterior maxilla. Current literature on this topic is limited, outdated, and primarily based on retrospective studies that lack long term follow-up. This study aims to investigate the impact of nasal septal surgery on anterior maxillary teeth sensation, focusing on the incidence, predisposing factors, and the timeline for sensory recovery.

Methods: This prospective study included 21 patients who underwent nasal septum surgery from September 2023 to September 2024. Patients with pre-existing conditions affecting dental sensation or those who recently underwent dental procedures were excluded. Sensory assessments were conducted preoperatively, post-topical anesthesia application, and at 10 days, one month, and three months post-surgery. Demographic data, surgical approach, and medical history were recorded.

Results: The cohort had an average age of 32.6 years (range 20-62), with 52% male participants. Significant temporary sensory loss was observed following the application of topical anesthesia (p=0.007). Postoperatively, sensory reduction occurred in two patients, resulting in a 9.5% incidence of sensory disturbances (p=0.4): one patient experienced numbness in all four incisors, while another reported numbness in the two central incisors. Both patients regained full sensation within one month after surgery. Multivariate analysis did not identify any significant predictive factors for sensory impairment, including surgical approach, presence of nasal fracture, or history of prior nasal surgeries.

Conclusion: Nasal septal surgery is associated with a low incidence of transient sensory disturbances in the anterior maxillary teeth, with full recovery typically occurring within one to three months. These findings suggest that careful surgical technique can minimize nerve injury and that the risk of permanent sensory loss is low. Additional research with larger patient cohorts is needed to validate these findings and identify possible risk factors, thus improving patient counseling and surgical techniques.