A Rare Complication Following Anesthesia: Arytenoid Dislocation During Orthognathic Surgery

Kai Liu; Junzi Yingwang; Lei Zhang; Biao Li; Jiewen Dai; Xudong Wang

doi:10.1016/j.joms.2018.11.029

A Rare Complication Following Anesthesia: Arytenoid Dislocation During Orthognathic Surgery

J Oral Maxillofac Surg. 2019 May;77(5):959-964. doi: 10.1016/j.joms.2018.11.029. Epub 2018 Dec 11.

Authors

Kai Liu¹, Junzi Yingwang², Lei Zhang³, Biao Li¹, Jiewen Dai³, Xudong Wang⁴

Affiliations

¹ Attending Physician, Department of Oral and Craniomaxillofacial Surgery, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Researcher, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China.
² Resident, Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Researcher, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China.
³ Professor, Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Professor, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China.
⁴ Professor and Chair, Department of Oral and Craniomaxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Professor, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China. Electronic address: xudongwang70@hotmail.com.

PMID: 30611687
DOI: 10.1016/j.joms.2018.11.029

Abstract

Purpose: Arytenoid dislocation is a rare complication after tracheal intubation, and there are no published studies reporting on arytenoid dislocation during orthognathic surgery. The frequency of this phenomenon and the results of therapy were evaluated in this study.

Materials and methods: Three of 5,032 patients who underwent orthognathic surgery during an 11-year period had a postoperative arytenoid dislocation. Closed reduction was used in these 3 patients. To check the therapeutic effect, arytenoid dislocation symptoms were recorded and acoustic analysis was performed before reduction, immediately after reduction, and 1, 2, and 4 weeks after reduction.

Results: The incidence of arytenoid dislocation in orthognathic surgery was 0.0596%. The symptoms of 2 patients showed marked improvement 2 weeks after reduction with voice recovery and resolution of odynophagia. The symptoms of the other patient showed marked improvement 4 weeks after reduction. The treatment effects for all 3 patients were satisfactory.

Conclusion: Arytenoid dislocation must be considered in cases of prolonged hoarseness after orthognathic surgery. Examination should be carried out as soon as possible, which can hasten the treatment of arytenoid dislocation and achieve a good outcome.

MeSH terms

Arytenoid Cartilage
Hoarseness
Humans
Intubation, Intratracheal
Joint Dislocations* / surgery
Orthognathic Surgery*
Postoperative Complications