Facial pain after diving

[knfmn]

Hello all,

This seems like the right place to ask this question. I went diving a couple of weeks ago and had some problems afterwards. I was only down 15-20 feet for about 30 minutes, but when I got out of the water the right side of my face/cheek was numb and hurting at the same time. It mostly seemed to be above my upper teeth. It was to the point that I actually got sick to my stomach, but it resolved itself when I laid down and slept for a couple of hours. Does anyone have any idea what might have caused this? I'm supposed to dive again this weekend and would be really happy if it didn't happen again!

Thanks for the help,

Kristopher

 

[warmwaterturner]

Just a thought but how hard are you biting on your mouth piece?

 

[knfmn]

Not that hard.

It was like the whole side of my face was numb and hurting at the same time. I don't think I could have bitten the mouthpiece hard enough to cause that. Thanks for the idea, though.

Kristopher

 

[pipefish]

Go have your sinuses checked out by an ENT - I know of someone who had congestion and put pressure on their facial nerve and caused the very symptoms you describe. Get it checked out and make sure your plumbing is okay before you dive again!

 

[knfmn]

Go have your sinuses checked out by an ENT - I know of someone who had congestion and put pressure on their facial nerve and caused the very symptoms you describe. Get it checked out and make sure your plumbing is okay before you dive again!

I wondered if it might be sinus related. I sure don't want to experience that again! I'll see what I can do r/e getting an appointment with an ENT this week.

Kristopher

 

[Bubbletrubble]

Very likely an incident caused by sinus barotrauma. In fact, there are several case reports of similar incidents of maxillary sinus barotrauma in the scientific literature.

Based on your description, your scuba-related injury involved the second branch of the trigeminal nerve (V2, infraorbital nerve) on the right side. In some individuals, a small hole can exist in the dorsolateral wall of the maxillary sinus. This hole, covered by a sinus membrane, can occur in the vicinity of a canal through which V2 runs. If pressure is transmitted to V2, either directly or via inflammation, then this could impact sensory function in the area. Not really a big mystery if one knows a little bit about facial anatomy (and any physician should know this).

You were lucky that the neurological dysfunction subsided on its own. Some people seek relief by using decongestants. Others require treatment with steroids for more serious, prolonged symptoms.

You may be at risk of having a similar thing happen in the future. It's also possible that, if you can take precautionary measures to avoid sinus congestion/inflammation, you won't have any further problems.

Bear in mind that there are myriad possibilities when it comes to talking about the size/shape of anatomical structures and the relative location of nearby structures. There may even be a situation that requires medical/surgical intervention. For instance, I have read at least one report of a patient having a cyst/growth in that area which was revealed by a painful diving incident.

Good luck with your ENT appointment. Don't be surprised if the ENT requests that an MRI be performed to get a better handle on your anatomy.

Hope this helps...

 

[TSandM]

BubbleTrubble nailed it. Consultation with an ENT doc is definitely warranted. You do not want to risk permanent damage to that nerve -- it's a thorough-going nuisance. (Says Lynne, who had a inferior orbital wall fracture and DID damage it, and still has a numb tooth.)

 

[Laurence Stein DDS]

This same question has come up before. Pain in the upper teeth/face then numbness part of the face/lips/teeth.

bubbletrouble is correct... sinus pressure compressing the sensory nerve, V-2 at the entrance to or within the infraorbital canal. This canal contains a portion of the second division of the Trigeminal nerve. The canal exits the bone just under the eye. This branch typically innervates a portion of the maxillary first molar and the maxillary bicuspids, part of the cheek and upper lip on the side supplied by that nerve.

The condition will usually resolve but it may recur if not treated.

Just to be clear, pipefish, the Facial Nerve (N VII) is a motor rather than a sensory nerve. It exits the base of the skull, passes through the parotid salivary gland and then travels across the face in the cheek area. Damage to this nerve doesn't cause numbness but, rather, paralysis of the facial muscles on an affected side.

However, a small branch of this nerve actually crosses the eardrum and is called the chorda tympani. This small branch is sensory and supplies taste to the tongue. I suppose it is possible to have an external/middle ear barotrauma which might affect a person's taste.

The motor portion of the facial nerve does not pass near or within the maxillary sinus and as such, it will not be affected by sinus barotrauma

Another case solved by the SB team! Go Bubbletrouble and TSandM!

 

[knfmn]

Ok. Thanks to all for your responses. Basically I need to go get my nerves checked out! I'm sure I can blame all the people at work who have been getting on them...lol.

Kristopher