Usefulness of the Blink Reflex in Diagnosing Isolated Infraorbital Neuropathy following Midface Augmentation with AlloPlastic Facial Implants: A Case Report

For the preoperative evaluation of infraorbital nerve injury, most clinicians depend on the patient’s subjective symptoms or judgements, lacking a generalized and objective evaluation method. Due to the limitations in subjective evaluations for accurate diagnosis of infraorbital nerve injury, we used the blink reflex to objectively evaluate injury to the infraorbital nerve. A 49-year-old female, who had previously undergone midface augmentation with alloplastic implants, presented with sensory loss in the left upper lip, nose tip, and lower palatal area. Physical examination revealed sensation loss in the area innervated by the infraorbital nerve. Facial three-dimensional computed tomography did not identify compression of the infraorbital nerve. The blink reflex study of the infraorbital nerve was evaluated preoperatively. After the patient was diagnosed with injury along the infraorbital nerve pathway from alloplastic facial implants, she underwent facial implant removal with decompression surgery. The patient experienced a significant decrease in hypoesthesia, and her sensory function improved. The blink reflex study was an effective method to objectively diagnose infraorbital neuropathy. Therefore, clinical use of the blink reflex study as an electrophysiological diagnostic tool is recommended to investigate infraorbital nerve injuries.