This Frankenstein of a patient is near and dear to me; she is my business partner Aimee. She suffered late mandibular bone growth in her mid-20′s, especially on her right side. Her surgery included, among other procedures, the filing down of her right mandible to reach better symmetry.
Post surgery she experienced periodic numbness and shooting pain down the right side of her neck. The above left photo shows Aimee’s post-op 3D scan. The above right photo shows that her beauty isn’t just bone-deep.
Now for the cause of that recurrent pain… if you clicked on the above 3D image to enlarge it, you probably saw the culprit. However, we prefer to show these cases from different angles to make it obvious and for patient education.
In reshaping the right mandible (done before 3D cone beam scans were invented), the alveolar nerve canal was actually bisected and the nerve is now exposed. When this nerve rolls outside of the remaining half-canal, the stretching/pinching effect causes the numbness and pain.
I told Aimee that she’ll be pain-free if she just stops talking. Now instead of verbally abusing me she throws things!