NERVE PARALYSIS AFTER SURGERY IN THE SUBMANDIBULAR TRIANGLE - REVIEW OF UNIVERSITY-OF-TOKYO-HOSPITAL EXPERIENCE

Background: We assessed the incidence of neural complications in subma ndibular surgery in relation to the type of surgery, experience of the surgeon, and other factors. Methods: We retrospectively reviewed the records of 133 patients who underwent excision of the submandibular tr iangle components at the University of Tokyo Hospital during the last 19 years. Results: The most frequent complication was mandibular branc h paralysis. Excluding 12 patients with malignant tumors, facial weakn ess was present postoperatively in 29.8% (37) of 124 resections. All p alsies subsequently resolved. The paralysis was more frequent when ner ve identification was performed than when it was not. Conclusions: The cardinal factors in minimizing incidence of nerve damage are an under standing of the anatomy of the nerves, low and generous skin incision, awareness of orientation in the surgical planes, avoidance of the use of metal retractors, and avoidance of elaborate identification of the nerve. (C) 1997 John Wiley & Sons, Inc.