title: A twin-center study of nasal tip numbness following septorhinoplasty or rhinoplasty.
abstract: Nasal tip numbness is a recognized postoperative complication after septorhinoplasty and rhinoplasty. We performed a twin-center retrospective study to determine the incidence of short- and long-term (>6 mo) nasal tip numbness after these procedures, and we studied several variables that might have been associated with this complication. Our study group was made up of 65 patients-31 males and 34 females, aged 15 to 67 years (mean: 30.5). Septorhinoplasty had been performed in 52 patients and rhinoplasty in 13; all surgeries were performed by two different surgeons at two different centers. There were 50 closed (endonasal) surgeries and 15 open surgeries. Follow-up phone calls made 6 to 37 months postoperatively revealed that 17 patients had experienced postoperative nasal tip numbness (26.2%); there were 10 cases of short-term numbness (15.4%) and 7 cases of long-term numbness (10.8%). Numbness resolved within 2 weeks in 8 of the 10 short-term patients. Of the 7 cases of long-term numbness, 6 patients reported severe numbness beyond 8 months, and 1 had mild numbness for at least a year. We found no association between the incidence of numbness and the type of surgery, the particular surgeon, or the particular center where the surgery had been performed. We did find that there was an association between long-term numbness and the open procedure, but it was not statistically significant. We discuss the possible mechanisms that might cause numbness in cases when the external nasal nerve is not cut. We believe it is important to include a discussion of the risk of nasal tip numbness during preoperative consultations and when seeking informed consent.
authors.affiliation: Corresponding author: Miss Marie-Claire Jaberoo, ENT Department, Level 5 Christchurch Hospital, 2 Riccarton Ave., Christchurch 4710, New Zealand. Email: mcjaberoo@gmail.com From the ENT Department, Christchurch Hospital, Christchurch, New Zealand (Miss Jaberoo); the ENT Department, Guy's Hospital, London (Mr. De Zoysa); the Royal National Throat, Nose and Ear Hospital, London (Mr. Mehta); the Department of ENT-Head and Neck Surgery, Ng Teng Fong General Hospital, Singapore (Mr. Prasad and Miss Heywood); the Department of Otolaryngology, Charing Cross Hospital, London (Mr. Saleh); and the ENT Department, Northwick Park Hospital, London (Mr. Marais). The study described in this article was conducted at Charing Cross Hospital and Northwick Park Hospital.
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Jaberoo
authors.forename: Neil
authors.initials: N
authors.lastname: De Zoysa
authors.forename: Nishchay
authors.initials: N
authors.lastname: Mehta
authors.forename: Vyas
authors.initials: V
authors.lastname: Prasad
authors.forename: Rebecca
authors.initials: R
authors.lastname: Heywood
authors.forename: Hesham
authors.initials: H
authors.lastname: Saleh
authors.forename: Joe
authors.initials: J
authors.lastname: Marais
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D009666:Nose / Q000294:innervation / Q000601:surgery; D009668:Nose Diseases / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult