Evaluation and treatment of painful sensation remains a challenge. There has been an attempt to evaluate sensibility in the face with less sensitive modalities such as the hand held static and moving two-point Disk-Criminator and vibratory and pressure thresholds. Kesarwani and Mackinnon as well as other authors have attempted to define facial sensibility and apply this knowledge to facial fractures. As sensory testing in this area is constantly evolving we evaluated the normal and abnormal cutaneous sensibility of the face with the Pressure-Specified Sensory Device (PSSD).

Values for facial sensibility were determined in 20 individuals bilaterally. Normal values were determined in two broad populations of healthy subjects (<45 & &gt;45 yrs). Similarly, abnormal sensation was measured in 10 patients who had blunt or penetrating facial trauma, or iatrogenic injury during aesthetic surgery. The time, extent of the injury (soft tissue or bone) and treatments modalities were determined. Sensibility was evaluated using the PSSD in 6 facial regions by the same technician. Each region was directly related to the area innervated by a division of the trigeminal nerve. Cutaneous sensibility predictively varied from one facial region to another and was consistent from one normal individual to another and between hemi-faces. The vermilion and mucosal surfaces of the lips were the most sensitive. The 99% upper limit of confidence was calculated, and abnormal defined as exceeding this. Abnormal values where obtained in patients with underlying facial trauma. . In this study we define regions that are best suited to measuring facial sensibility and provide normal measurements of cutaneous sensation in the face that can serve as standards in assessing abnormal sensibility. The availability of PSSD testing provided useful knowledge of normal sensation to evaluate and possibly treat problems of altered sensation in patients with facial trauma.