Facial Numbness After Cheekbone Surgery: Next Steps - Family Medicine

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Understanding facial numbness after cheekbone surgery can be quite complex, especially given your history of trauma and surgical intervention. It’s important to recognize that the facial nerves are intricate and can be affected by various factors, including previous injuries, surgical procedures, and even the placement of hardware like titanium plates.

From your description, it seems that you experienced a significant injury to your cheekbone and eye socket, which required surgical repair. The fact that you had a period of numbness that resolved on its own after six months is a positive sign, indicating that some nerve regeneration occurred. However, the recent resurgence of numbness and loss of sensation in the same area is concerning and warrants further investigation.

Given that imaging studies (like CT scans) have shown no abnormalities in the bone or metal implants, and that specialists in neurology and neurosurgery have not found any significant issues, it may be beneficial to consider a few additional avenues:
1. Oral and Maxillofacial Surgery: Since your symptoms are localized to the facial region, consulting with an oral and maxillofacial surgeon could provide insights. These specialists are trained to handle complex facial structures and may offer a different perspective on the nerve function and any potential issues related to the surgical site.

2. Pain Management Specialist: If the numbness is associated with discomfort or pain, a pain management specialist could help. They may offer treatments such as nerve blocks or other interventions that could alleviate symptoms.

3. Physical Therapy: Engaging in physical therapy focused on facial rehabilitation may help improve nerve function and reduce symptoms. A therapist can work with you on exercises that stimulate the facial muscles and nerves, potentially aiding in recovery.

4. Electromyography (EMG) and Nerve Conduction Studies: If not already done, these tests can evaluate the electrical activity of your muscles and the speed of nerve conduction. They can help identify any nerve damage or dysfunction that may not be visible on imaging studies.

5. Psychological Evaluation: Sometimes, chronic pain or numbness can be exacerbated by psychological factors. Consulting with a psychologist or psychiatrist may provide support and coping strategies, especially if you are experiencing anxiety related to your symptoms.

6. Follow-Up with Your Primary Care Physician: Since you mentioned seeking advice from a family medicine doctor, they can coordinate your care and help you navigate referrals to the appropriate specialists based on your evolving symptoms.

In terms of your specific symptoms, the transient nature of the numbness you experienced could suggest that there are still some nerve pathways that are recovering. The fact that pressure on the left side of your face affects your teeth could indicate that the trigeminal nerve, which supplies sensation to the face and teeth, might be involved.
It’s essential to keep a detailed record of your symptoms, including when they occur, their duration, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and managing your condition.

In conclusion, while it can be frustrating to navigate through various specialists without a clear answer, persistence is key. Continue to advocate for yourself and seek out the appropriate specialists who can help you understand and manage your symptoms effectively. Your health and well-being are paramount, and with the right approach, there is hope for improvement in your condition.