Lingual nerve paresthesia after endoscopic laryngeal surgery

Objectives: To investigate demographic, anatomical, procedural, and intraoperative variables associated with the development of LNP.Methods: A total of 196 adult patients who underwent SL were retrospectively analyzed. Patients were divided into two groups: those who developed LNP (n = 38) and those who did not (n = 158). The two groups were compared regarding the demographic, anatomical, procedural, and intraoperative variables under investigation.Results: Among 196 patients, 38 (19.4%) developed lingual nerve paresthesia (LNP), significantly more common in females (71.1% vs. 34.8%, p < 0.001). LNP was associated with a two-finger inter-incisor gap (68.4%, p = 0.004), large tongue size (68.4%, p < 0.001), and higher Mallampati scores (Class III–IV in 63.2%, p < 0.001). Difficult airway management was more frequent in the LNP group during preoperative (57.9% vs. 7.0%, p < 0.001) and intraoperative phases (28.9% vs. 6.3%, p < 0.001). LNP patients had longer surgeries (≥21 minutes in 84.3%, p < 0.001), and more often had the tube on the affected side (76.3%, p < 0.001).Conclusion:Female gender, limited inter-incisor gap, large tongue size, high Mallampati score, procedural difficulties, prolonged operation time, ipsilateral tube placement, and smaller tube size are significant risk factors for lingual nerve paresthesia following suspension laryngoscopy.