Pharyngeal Complications Following Two-Jaw Surgery

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.