RESUMO
This study reports a case who presented with swallowing difficulty after orthognathic surgery. A female patient, who had undergone orthognathic surgery for esthetic purpose, presented with dysphagia. Administration of botulinum toxin injection to the cricopharyngeus muscle did not relieve or improve the severe dysphagia. The patient required nasogastric tube feeding for about three months. Swallowing ability was recovered after daily rehabilitation therapy and prescribing pyridostigmine. Injuries to the suprahyoid muscles (involved in laryngeal elevation during the pharyngeal phase of swallowing) during orthognathic surgery, and the inadvertent dissemination of inadequately injected botulinum toxin to adjacent muscles, are possible mechanisms of the severe dysphagia experienced by this patient. The authors also reviewed literature on the prevention and management of dysphagia following the orthognathic surgery.
RESUMO
The rate of traumatic or nontraumatic optic neuropathy has increased in recent decades. High dose steroid, surgery and combined treatment are used for management of optic neuropathy. Surgical intervention using an endoscopic intranasal approach is expected to provide a safe and effective method for optic nerve decompression. We present outcomes of three patients with neuropathy who underwent endoscopic optic nerve decompression. Of the three patients, two showed improvement: from hand motion to 0.8 and 0.63, respectively. However, one patient who was not able to perceive light did not improve vision after surgery. The difference between the recovered patients and the patient who did not show improvement may be a result of initial visual acuity. Early diagnosis and prompt surgical management could increase the likelihood of improved visual performance; however, this may be limited to patients whose initial visual acuity is better than light perception.