We report a case of postoperative airway stenosis caused by a hematoma following a lingual nerve repair procedure under general anesthesia. The patient was a 66-year-old man with hypertension, diabetes mellitus, hypertrophic cardiomyopathy, and a long history of smoking. The nerve repair procedure was completed without any problems, and the patient was returned to the ward. Two hours after returning to the ward, the patient developed severe nasopharyngeal stenosis requiring the emergency removal of a hematoma under general anesthesia. Although hemostasis of the wound was achieved, residual swelling of the soft palate and floor of the mouth eventually required a tracheotomy. Nerve repair is not yet a common procedure in oral and maxillofacial surgery. We have performed 28 nerve restorations over a five-year period, with an average blood loss of only 29.5 ml. In addition, we have never previously observed airway narrowing during nerve repair surgery. We hypothesized that the postoperative bleeding in the present case was caused by multiple factors including systemic factors, such as hypertension, diabetes, and a history of smoking, as well as local factors arising from the surgical procedure. In the future, the risk of airway narrowing during nerve repair surgery should be kept in mind so that potential risks can be anticipated prior to surgery.
