Conditions: Numbness on and around the ear after facial surgery
(great auricular neuropathy)
What is the great auricular nerve?
The great auricular nerve provides sensation from the skin in an area involving part of the outer ear, and part of the skin near the ear.
Why is the great auricular nerve affected by surgery?
The great auricular nerve runs close to the skin surface, and some or all of it travels through the parotid gland. Some operations cannot be accomplished without cutting (sacrificing) all or part of this nerve.
What are the symptoms of great auricular neuropathy?
Abnormal sensations, including numbness or lack of sensitivity but also stinging, burning, discomfort, and hypersensitivity have been reported after sacrifice of the great auricular nerve.
What precautions are necessary with great auricular neuropathy?
If someone has a patch of numb skin on the ear, use of a curling iron must be done with care, as contact may burn the skin without a quick reaction. Mindfulness of this risk is a simple precaution. Alternatively, for cold weather sports, an exposed numb ear may not feel very cold and frostbite may set in before it is noticed unless the opposite ear is used as an indicator of how cold both ears may be. Covering the ears in extreme cold is a simple safety measure.
HOw is great auricular neuropathy prevented?
During surgery between the ear and the cheek or in the neck by the ear lobe, the great auricular nerve and its branches are at risk of injury. For some operations, this nerve must be sacrificed in order to properly perform the procedure, such as removal of a tumor or lymph nodes. Some operations remove this nerve to be used as a replacement (graft) to repair a different nerve. When the anatomy is favorable, sometimes this nerve or a branch of it may be preserved without compromising the effectiveness of the operation.
How much will great auricular neuropathy bother someone?
About 75% of patients who underwent sacrifice of the great auricular nerve during parotid surgery reported the degree of bother from abnormal sensations from great auricular neuropathy to be “none,” “almost none,” or “a little.” Only 3% reported the degree of bother to be a tremendous amount.
Does great auricular neuropathy improve over time?
Yes, the symptoms of great auricular neuropathy decreases significantly over time. Symptoms tend to decrease rapidly in the first two years after surgery, and continue to decrease to become close to zero by six years after surgery.