A Rare Complication Following Anesthesia: Arytenoid Dislocation During Orthognathic Surgery.


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: [Email]


OBJECTIVE : 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.
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.
CONCLUSIONS : 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.

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