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Eye watering, numb lips. Done eardrum replacement surgery. Should there be numbness in the facial area?

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replacement eardrum surgery Should I have numbness in my facial area? Right eye is watering, lips numb on right sides.And I can't close the right ear all the way.
Posted Wed, 4 Jul 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. Ideally, you should not have these symptoms after ear surgery.

2. The Facial Nerve (Seventh Cranial Nerve) has the longest course (around 3 cm) in a three dimensional zig-zag bony canal through the temporal bone which houses the ear. A branch (Chorda Tympani) exits the Facial Nerve in the middle ear and travels across the eardrum.

3. This proximity makes it especially vulnerable to injury during ear operations. If the nerve is dehiscent (no bony covering) it is more prone to damage during ear surgery. Sometimes the Chorda Tympani branch is stretched. Since nerves are very delicate, even the slightest touch or suction near them can cause considerable trauma.

4. If the symptoms have occurred during or immediately after surgery, this may also be due to local anesthetic infiltrated near the nerve or coming in contact with it. This causes transient Facial Palsy.

5. If the symptoms have appeared some time after ear surgery, there is more likely hood of this being transient and recovery should follow. You must draw this to the attention of the surgeon and start steroids.

6. The face is supplied sensation by the Trigeminal Nerve (Fifth Cranial Nerve). Heaviness similar to numbness is experienced during Facial Nerve Palsy. The Chorda Tympani Branch supplies taste to the anterior one third of the tongue and secretomotor fibers to the submandibular and sublingual salivary glands.

7. Transient changes are often seen after eardrum surgery. The incidence of injury to the Facial Nerve during ear surgery is less than 5% in primary cases and up to 10% in revision surgeries. Discussion on this issue without adequate details and further discussion on all scenarios and possibilities is beyond the scope of this initial answer.

8. If your symptoms persist, high dose steroids, eye care and physiotherapy is required. If there is doubt of injury, imaging scans and revision surgery may be necessary. Nerve Conduction Studies (NCS) and ElectroMyoGraphy (EMG) done after 10 days to two weeks gives an idea of the extent of injury to the nerve.

I must emphasize that you should draw your surgeons attention to this immediately. Get a second opinion, if necessary.

Kindly follow up with your timeline and details for further guidance.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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