The numb chin syndrome occurs when there is injury to the inferior alveolar or mental nerves. It results in numbness with or without paresthesias over the chin and the left or right side of the mandible. It may be the presenting symptom for an occult malignancy.

Non-neoplastic causes:

(1) injection or other iatrogenic trauma

(2) noniatrogenic trauma

(3) odontogenic infections

(4) HIV infection

(5) mandibular osteomyelitis

(6) Lyme's disease

(7) syphilis

(8) mandibular atrophy in the elderly, especially with dentures

(9) vasculitis

(10) sarcoidosis

(11) amyloidosis

(12) sickle cell disease


Neoplastic causes:

(1) odontogenic tumors

(2) metastatic carcinoma

(3) acute leukemia

(4) malignant lymphoma


If non-neoplastic causes are excluded then the patient should be worked up for a neoplastic cause:

(1) panoramic radiographs of the mandible

(2) CT or MRI imaging of the head and neck

(3) lumbar puncture

(4) hematologic evaluation

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