Qualitative Sensory Testing In Orofacial Cysts and Tumors and Its Correlation with Cone-beam Computed Tomography Findings: A Narrative Review

AbstractBackground: Orofacial cysts and tumors may produce sensory disturbances when they develop in close proximity to the inferior alveolar nerve (IAN), mental nerve, or other branches of the trigeminal nerve. Neural dysfunction may result from compression, displacement, inflammation, cortical destruction, or direct neural involvement. Although patient-reported paresthesia is clinically important, subtle sensory abnormalities may remain undetected without systematic neurosensory examination.Objective: This narrative review discusses the role of qualitative sensory testing (QualST) in patients with orofacial cysts and tumors and examines its potential correlation with cone-beam computed tomography (CBCT) findings, particularly the relationship between jaw lesions and the mandibular canal.Materials and Methods: A narrative literature review was performed using PubMed/MEDLINE and relevant peer-reviewed literature addressing qualitative and quantitative sensory testing, trigeminal neurosensory assessment, inferior alveolar nerve dysfunction, CBCT evaluation of the mandibular canal, and jaw cysts and tumors. Studies directly addressing sensory assessment or radiographic evaluation of lesion nerve relationships were prioritized.Results: QualST is a simple chairside method for identifying clinically apparent alterations in somatosensory function. Common modalities include light touch, pinprick, thermal sensation, and two-point discrimination. Evidence suggests good agreement between QualST and quantitative sensory testing when sensory function is normal, although its ability to identify subtle sensory ¹ abnormalities is limited. Clinical neurosensory testing has demonstrated useful diagnostic ² accuracy in patients with trigeminal nerve injuries. CBCT provides three-dimensional visualization of jaw lesions and their relationship with the mandibular canal, including canal 3,8 displacement, narrowing, cortical interruption, and destruction. Studies of ameloblastoma and keratocystic odontogenic lesions demonstrate that these lesions may significantly alter the 5,6,8 position and morphology of the mandibular canal. However, radiographic proximity or displacement of the canal does not necessarily indicate functional nerve impairment.Conclusion: QualST and CBCT provide complementary information. QualST evaluates sensory function, whereas CBCT evaluates anatomical involvement. Their combined use may provide a more comprehensive assessment of neural involvement in patients with jaw cysts and tumors. Prospective studies using standardized sensory protocols and quantitative CBCT measurements are required to establish the relationship between radiographic nerve involvement and clinically detectable sensory dysfunction.