Supratrochlear Nerve Damage from Open Rhinoplasty Possible?

I had a massive amount of swelling after open rhinoplasty (the glabella area just above the outer cast was the worst). The swelling caused the cast to dig into the skin around my eyes and glabella region. I also had 18 hrs of steady bleeding which sent me to the ER. Also, antibiotics were ordered a couple days after that due to what appeared to be an infection. After 2 days on antibiotics things are improving but the pain in my scalp still exists - just my hair has been pulled back tight.

Doctor Answers (5)

Damage to supratrochlear nerve would be uncommon

+1

Hello MB,

Thank you for the question.  It sounds like you have had a unique rhinoplasty recovery.  From the anatomy standpoint, direct injury to the supratrochlear nerve would be very uncommon.  Its not impossible but direct dissection in that area would be needed and although it is somewhat close to the nose it is quite unlikely that dissection in that area would be needed for a rhinoplasty.  The good news is that even if it was injured it will likely heal well on its on.  When patients have facial fractures that involve these nerves they have  numbness that inevitably returns on its own.

All the best,

Dr. Remus Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 87 reviews

Supratrochlear Nerve Damage from Open Rhinoplasty Possible?

+1

While just about anything is possible, creating an injury to that nerve with an Open Rhinoplasty would seen very unlikely as it is well outside the area of tissue dissection.  It might temporarily occur from local infiltration to block the cutaneous sensory nerves across the eyebrow area.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Supratrochlear Nerves and Rhinoplasty

+1

There may be pressure on the nerve from the swelling and bruising but it would be very difficult, if not impossible, to injure the nerve on the brow ridge from a rhinoplasty procedure.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 reviews

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Supratrochlear Nerve Damage from Open Rhinoplasty Possible?

+1

Dear MBGirl,

Thank you for your question.  It is highly unlikely that the nerve was damaged during surgery. Much more likely that it was pressed upon by the swelling, etc.  This is known as neuropraxia and resolves with time.  Withing days to months depending on the extent of damage, the nerve should return to normal.  Monitor it with your plastic surgeon, keep your head elevated at night when you sleep, take anitinflammatories like ibuprofen on a scheduled basis, and be patient.  

Best Wishes, 

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

Low likelihood of Supratrochlear nerve damage.

+1

Hello MBGirl,

Thanks for your question.  It would be difficult for a surgeon to injure the Supratrochlear nerve during rhinoplasty because the nerve exits the orbital bone medially near the corner of the eye.  You seem to have had a lot of inflammation/infection is the region and this can be inhibiting the transmission of the nerve.  Supratrochlear nerve problems manifest as numbness in the central forehead and anterior scalp.  My guess is that as the inflammation/infection/swelling in the glabellar area goes down, the nerve will be less compressed and "wake up."  I would give it some time.  Just watch clinically to make sure that the antibiotics are continuing to improve the situation.  

Good luck,

Dr. Shah

 

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
5.0 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.