Vocal fold paralysis after two-jaw surgery

Abstract

Two-jaw surgery is a surgical procedure performed for jaw deformities, which is associated with a high rate of postoperative vocal cord paralysis. In the present study, we statistically analyzed the frequency of vocal cord paralysis after two-jaw surgery and discussed the causes. A total of 133 patients who underwent two-jaw surgery at our hospital's Department of Oral Surgery between September 2019 and July 2022 were retrospectively analyzed. Of the 133 patients, 13 (9.8%) had postoperative vocal cord paralysis. The improvement rate was 100%. In various reports, the frequency of postoperative vocal cord paralysis after two-jaw surgery was 0.03-0.2%. In addition, laryngeal granulation was observed in 6 of 20 patients who complained of postoperative hoarseness. It was considered that the surgical operation involves a large amount of mechanical stimulation to the larynx due to the movement of the intubation tube during the surgical operation, and stimulation of the vocal cords is one of the causes of vocal cord paralysis. In some cases, submucosal hematomas were observed in the hypopharynx and larynx, which may have caused vocal cord paralysis due to compression of the tissue surrounding the recurrent nerve and the recurrent nerve nutrient vessels, resulting in hypoperfusion. In the future, it will be necessary to inform the medical and dental communities of these cases.