Nerve damage is one of the main risks of having
orthognathic surgery. Nerve injuries can be caused by direct or indirect trauma
to the nerves. Indirect trauma can be in the form of compression or swelling.
Or direct trauma, caused by the nerve being stretched or cut during the
operation. There are many nerves in your face that help with sensation and
movement. During orthognathic surgery the two main nerves at risk are; the
trigeminal nerve and the lingual nerve. The trigeminal nerve has three branches
that spread across the side of your face and the lingual nerve serves the front
2/3rds of the tongue.
After lower jaw surgery it is expected that patients
will feel numbness or pins and needles around the chin, lower jaw and lip area.
This is completely normal and should only be temporary. In most cases the lower
numbness starts to wear off within a couple of weeks. However, sometimes it can
take up to 12-18 months for full sensation to return to the area. In a few
cases the numbness may become permanent. As the muscles will be unaffected, the
numbness should not restrict you from speaking properly or using your lip or
lower jaw in the future.
If you are undertaking upper jaw surgery the area of
numbness may be larger. With upper jaw surgery it would be expected for the
patient to feel numb from the eye area downwards. The numb area can spread down
the face and cause numbness in the upper lip, gum and teeth. As with the lower
jaw surgery the upper numbness should start to fade between 8-12 weeks and full
sensation would be expected within 12-18 months.
Finally, there may be a risk of damage or sensory loss
to the lingual nerve following lower jaw surgery. This nerve controls the
feeling in the front two thirds of the tongue and is responsible for taste.
Although this is a recognised complication of orthognathic surgery it tends to
be rare. This particular problem is usually associated with a patient who has
had their nerve stretched or bruised by retraction during the operation.
My Case
In my case, when I woke up from surgery I was in a
huge amount of pain, however, I could not feel my face from the eye socket
down. Due to my unique anatomy my trigeminal nerve was in a different position
from everybody else’s. My surgeon had not known this fact and had accidently
cut the nerve during surgery. My surgeon stitched back the nerve on the left
side of my face and hoped that it would make a full recovery. During the first
few weeks that followed surgery, I would find myself stroking my eyebrows as
these were the only things I could feel on my face. It brought me some sort of
comfort knowing I could touch my face.
In the early stages of recovery my face felt fuzzy or
hot. I could not feel my teeth, gum,
nose, cheeks, chin or lips. If I touched the face, it felt as if someone had
poured a glass of water down my face. In the weeks that followed the water
running down my face sensation seemed to intensify and sometimes I would not be
able to concentrate. I also had periods of a few days where I lost sensation in
my tongue. The first time this happened I was lying in bed at night on my own
and the sensation just disappeared. Because I had a blocked nose, I was
breathing through my mouth. When the feeling left I could no longer feel the
air flow on my tongue and started to panic. No one at the hospital had
mentioned anything to do with my tongue being numb after jaw surgery. However,
due to my high level of exhaustion from not sleeping for weeks, I decided to
slow my breathing and concentrated on taking deep breathes. I used a syringe to
have some cold water and this is when I realised my tongue was numb. I could
not feel the cold water on my tongue and could only feel the coldness once the
water had hit the back of my throat. The next day I had soup through a syringe
and I had the same issue. I could not feel the warm soup and I could not taste
the soap either. When I visited the hospital next, my orthodontist assessed me
and said that it was normal to have tongue numbness and as mine was only coming
and going it should only be temporary.
After this phase in recovery, there came the
relentless itching and the pins and needles in my face and lips. This was
highly annoying. As I was so sore, swollen and in pain, it was very hard to
touch my face. I would try to distract myself when I had these attacks of
itching. I saw this as a positive thing that my nerves were starting to wake up
and heal at last.
In total, I would say it took 3 months to regain most
of my feeling back in my face. I still have permanent numbness in both sides of
my lower lip, chin and teeth, but I am learning to live with this. I would much
prefer this, than to have nerve pain or constant pins and needles. The lower
numbness does make me self-conscious and I do worry when I go out to
restaurants or bars. I usually have a napkin to hand whilst I eat and take a
small hand mirror with me in my purse to check my face after I have finished
eating or drinking. My friends and family are understanding and would never let
me walk around with food around my chin (well apart from that one time, thanks
guys). I tend to use a straw when I drink as this gives me more control about
where the liquid is going. I also use cups with small lips at the top, as this
makes it easier for me to drink from than large rimmed cups or glass tumblers.
To read more about the risks involved in Orthognathic
Surgery and to get more information and tips on how to help regain feeling in
your face and reduce swelling….. why not download my “Jaw Surgery Survival Pack”?
Feel free to message me and add me on social media
As always, sending my love and hugs
Steffie xx
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Read about my jaw surgery recovery on....
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Lots of love always,
Steffie
x.x.x
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