Oropharyngeal complications of suspension laryngoscopy: a prospective study.

Objective: This study was designed to evaluate the oropharyngeal complications of suspension laryngoscopy (SL).

Methods: We prospectively analyzed 56 consecutive SLs for intervention-related complications. Oropharyngeal symptoms and physical examination abnormalities were recorded before and after SL. SL-related problems were graded in severity and followed over time (weekly) until resolution was achieved. All patients had SL with either a gallows suspension or a manual technique and not a rotation-oriented (fulcrum) laryngoscope holding device.

Results: Oropharyngeal minor complications after SL occurred at a rate of 37.5%, and all these were temporary. No dental injuries occurred in the study cohort. There were no major complications after SL. Minor alterations related to taste occurred in 18% of the patients, 16% of patients had subjective swallowing complaints, and 12.5% had partial tongue numbness. Average duration of the post-SL complaints was 11 (6-34) days. A correlation between duration of suspension, size of laryngoscope, and risk of developing a minor oropharyngeal complication was present.

Conclusion: SL carries a higher risk for lingual and glossopharyngeal nerve injuries than previously recognized. All of these complications were temporary. On the basis of comparison with historic data, SL by gallows suspension technique may pose a lower risk of dental injuries. This information should be used to improve preoperative SL patient education and informed consent.