Risk Factors for Lingual Nerve Injury Associated With Suspension Laryngoscopy

This prospective study was designed to identify risk factors for lingual nerve injury as a complication of suspension laryngoscopy.

Fifty-six adult patients (19 females and 37 males) who underwent microlaryngeal surgery (MLS) using the suspension laryngoscopy procedure under general anesthesia at our otorhinolaryngology department between January 2016 and January 2018 were enrolled in this study. All operations were performed using only a cold-steel microlaryngeal surgical set, and operations using laser and radiofrequency energy were not included. Unilateral or bilateral paresthesia, numbness of the tongue, and/or a change in taste sensation (dysgeusia) were considered to indicate lingual nerve injury.

Operation time and difficulties during intraoperative intubation and/or suspension of the larynx were major risk factors for lingual nerve injury following suspension laryngoscopy ( P = .015 and P = .011, respectively). Difficulties in preoperative flexible fiberoptic examination and intraoperative laryngeal compression were not found as risk factors, and the associations were not significant. Additionally, females showed a higher complication rate of lingual nerve injury following suspension laryngoscopy than males.

From a medical-legal standpoint, although lingual nerve injury is not a life-threatening complication, it is important to inform patients, especially those expected to undergo long-duration surgery.