Yamano Takafumi, Tanaka Takayuki, Kimura Shoichi, Omori Fumitaka, Wada Kaori, Yokoo Yoshinobu, Izumi Kiwako, Nakamichi Chinatsu, Ikeda Mizuko
Section of Otorhinolaryngology, Department of Medicine, Fukuoka Dental College, Fukuoka, JPN.
Department of Otorhinolaryngology, Fukuoka Dental College Hospital, Fukuoka, JPN.
Cureus. 2024 Dec 28;16(12):e76539. doi: 10.7759/cureus.76539. eCollection 2024 Dec.
Two-jaw surgery corrects jaw deformities by adjusting occlusion and reshaping the jaw. This technique carries a high risk of pharyngolaryngeal injury due to frequent head and neck movements during intraoperative maneuvers and prolonged intubation, although the details remain unclear. This study explored the frequency and causes of postoperative pharyngeal complications following maxillary translocation.
Between September 2019 and July 2022, 133 cases of two-jaw surgery (36 males and 97 females; mean age: 26.4 years; age range: 17-55 years) were performed in our dental and oral surgery department. Postoperatively, patients with hoarseness or pharyngeal discomfort were immediately referred to the ear, nose, and throat department to assess the pharyngeal larynx by nasal endoscopy. Patients with and without pharyngeal lesions (such as vocal cord paralysis and laryngeal granulation) were compared.
The mean age, sex ratio, operative time, and blood loss were compared between groups with and without vocal cord paralysis. There was a statistically significant difference between the groups in terms of the sex ratio. No significant differences were found between groups with and without laryngeal granulation.
Vocal fold paralysis and laryngeal granulation were attributed to mechanical irritation of the larynx due to movement of the intubation tube during surgery, and perilaryngeal tissue compression due to hematoma and pharyngolaryngeal edema.
双颌手术通过调整咬合和重塑颌骨来矫正颌骨畸形。尽管具体细节尚不清楚,但由于术中操作时频繁的头颈部移动和长时间插管,该技术存在较高的咽喉损伤风险。本研究探讨了上颌骨移位术后咽部并发症的发生率及原因。
2019年9月至2022年7月期间,我们口腔颌面外科进行了133例双颌手术(男性36例,女性97例;平均年龄:26.4岁;年龄范围:17 - 55岁)。术后,出现声音嘶哑或咽部不适的患者立即被转诊至耳鼻喉科,通过鼻内镜评估咽喉情况。对有和没有咽部病变(如声带麻痹和喉部肉芽)的患者进行比较。
对有声带麻痹和无声带麻痹的两组患者的平均年龄、性别比、手术时间和失血量进行了比较。两组之间在性别比方面存在统计学上的显著差异。有和没有喉部肉芽的组之间未发现显著差异。
声带麻痹和喉部肉芽归因于手术期间插管移动对喉部的机械刺激,以及血肿和咽喉水肿导致的喉周组织压迫。