Complications of Suspension Laryngoscopy

Abstract

Although suspension laryngoscopy (SL) is routinely used in operative laryngology, no prospectively gathered data on the complications of this procedure have so far been available. We prospectively analyzed 339 consecutive procedures for intervention-related complications. The survey included preoperative dental status and assessment of postoperative dental, mucosal, and nerve injuries. Minor mucosal lesions were found in 75% of all patients. All healed spontaneously within a few days. Dental injuries occurred in 6.5% of all patients. These were more frequent in therapeutic laryngoscopy than in diagnostic procedures (6.8% versus 6.0%). Highly significant correlations were found between dental injury rate and preoperative dental disease (p < .04) and grade of periodontitis (p <.001). Temporary nerve lesions were observed in 13 patients (9 of the lingual nerve and 4 of the hypoglossal nerve). Although minor complications frequently occur during SL, it is a relatively safe procedure with a low risk of significant morbidity.

Gustatory function after microlaryngoscopy

“…tooth extraction [11] or uvulopalatopharyngoplasty [12], MLS [4 Á6]) or even intubation, only a few studies have systematically investigated the occurrence of taste disorders after MLS [1,9,13]. With one exception [13], these studies have not measured taste function, but solely asked the patients whether they experienced taste dysfunctions [1,3,9]. Patients' subjective reports reflect the qualitative taste disorders but barely correlate with the quantitative gustatory function.…”

“…Previous studies [1,3,9] and case reports [2,4 Á6] found transient qualitative taste disorders (dysgeusia, parageusia, metallic taste) to occur in approximately 10% of MLS patients. The authors speculated that these transient taste disorders were due to tongue compression.…”

Complicações extralaríngeas das cirurgias por laringoscopia direta de suspensão

“…The idea we had is that only the corda tympani nerve fibers were injured during the procedure. We did not find in the literature any other study investigating lingual nerve function deficit by stimulating the corda tympani nerve fibers, which are part of it, as aforementioned [4][5][6][7][8][9][10] . Taste evaluation was carried out as a means to broaden or confirm SL-related lingual nerve injury.…”

“…1 Despite its routine use today, there are very few studies in the literature dealing with possible complications to this procedure. Most of them are restricted to doing a retrospective analysis of the complications, without any preoperative analysis 4 . Even then, literature shows that minor complications such as dental and mucosal lesions (mild bleeding, bruises, blunt or cutting wounds) happen in 9.1% to 31% of the patients who undergo direct laryngoscopy.…”

Indications des laryngoscopies en suspension

“…Les indications des laryngoscopies directes sous anesthésie générale ou laryngoscopie en suspension (LES) sont nombreuses dans un but diagnostique et/ou interventionnel (1). La LES est réalisée aux fins de diagnostic des pathologies laryngées morphologiques, neurologiques, inflammatoires et tumorales.…”