Anesthesia · single question

After an inferior alveolar nerve block, the patient cannot close their eye. Which nerve was inadvertently anesthetized?

  1. Optic nerve (CN II)
  2. Facial nerve (CN VII)
  3. Ophthalmic nerve (CN V1)
  4. Oculomotor nerve (CN III)
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Correct answer: B. Facial nerve (CN VII)

If the needle is inserted too far posteriorly/deep during an IANB, anesthetic can be deposited into the body of the parotid gland, where branches of the facial nerve (CN VII) travel. This causes a transient facial palsy, including the inability to close the eyelid (orbicularis oculi is facial-nerve innervated). It resolves once the anesthetic wears off; the eye should be protected/patched in the meantime.

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