Peripheral Facial Nerve Paralysis After Upper Third Molar Extraction

Abstract

Peripheral facial nerve paralysis (PFNP) after mandibular interventions has been reported in the literature. In most cases, paralysis begins immediately after the injection of the mandibular anesthesia, and duration of facial weakness is less than 12 hours. However, there are few documented cases of PFNP after maxillary dental or surgical procedures. A variety of mechanisms have been associated to PFNP, including viral reactivation, demyelination, edema, vasospasm, and trauma. The purpose of this presentation was to report a rare case of facial paralysis that occurred after an upper third molar extraction. The cause of the PFNP and the importance of the multidisciplinary approach in the management are emphasized.

Complications Associated with Local Anesthesia in Oral and Maxillofacial Surgery

“…For 4 weeks, galvanic stimulation of the affected side of the facial nerve was performed, and mime therapy was recommended. In 2 weeks all of the symptoms disappeared [45].…”

Complications Following Surgery of Impacted Teeth and Their Management

“…The inferior alveolar nerve (IAN), lingual and mental nerves are the most prone to injury during anesthesia and surgical procedures [35][36][37][38]. However, available literature describes a case of facial nerve injury during upper third molar surgery [39].…”

“…In cases of maxillary third molar surgery, facial nerve paralysis may develop after local dental block anesthesia or even after tooth extraction [9,39]. Although the mechanism of development after dental procedures is unknown, there are three explanations of its occurrence such as: Direct trauma to the nerve from the needle, intraneural hematoma formation or compression and local anesthetic toxicity.…”

“…However, a blast of air into the tissue with dissection through the fascial spaces mayalso cause facial nerve paralysis. Thus, forced air while cleaning an extraction site should not be used [39].…”

A Case Report on Facial Nerve Palsy after Tooth Extraction and Korean Medical Treatments※

“…. 치과 치료 후 발생하는 안면 신경 마비는 대부분 일시적이며 마취액의 효과가 소실되면 서 저절로 회복되나 4,5) , 국내의 2편의 연구 6,7) , 국외의 8편 의 연구 [8][9][10][11][12][13][14][15]…”