Charlin'S Syndrome Following a Routine Septorhinoplasty

Abstract

There are some rare but probable devastating complications following any rhinoplasty. Charlin's syndrome is a typical one. It is completely related to the external nasal nerve. In this report, we are presenting a 21-year-old female with signs and symptoms of Charlin's syndrome, persisting for 4 years after a routine septorhinoplasty operation. Surgery was uneventful and the patient underwent bony septal resection and caudal septal relocation. Osteotomy was internal low to low and external transverse bilaterally. Overall, a routine septorhinoplasty was executed. Everything went well postoperatively, until 4 months after surgery, when some irritating symptoms developed and gradually intensified.

Keywords: Charlin’s syndrome; Complication; Septorhinoplasty.

Fig. 1

V1 branch of 5^th cranial nerve. (from Frank. H. Netter: Atlas of human anatomy. 6^th edition. Elsevier. 2014).

Fig. 2

Anterior ethmoidal nerve. (from Frank. H. Netter: Atlas of human anatomy. 6^th edition. Elsevier. 2014).

Fig. 3

Preoperative photos. She refused a simultaneous genioplasty.

Fig. 4

1 month postoperative photos.

Fig. 5

Postoperative coronal CT of th nasal area. Caudal septal relocation and bilateral open airway are evident.

Fig. 6

Postoperative axial CT shows corrected septal deviation, open airway, and almost normal view of the area.

Fig. 7

The patient with her chief complaint: persistent unilateral rhinorrhea.

Fig. 8

Patients suffering from Charlin’s syndrome present with the complaint of severe paroxysms of ocular or retro-orbital pain that radiates into the ipsilateral forehead, nose, and maxillary region. The pain is associated with voluminous ipsilateral rhinorrhea and congestion of the nasal mucosa and significant inflammation of the affected eye (from Waldman SD: Atlas of uncommon pain syndromes. 3rd ed., Elsevier 2013).