title: Nerve paralysis after surgery in the submandibular triangle: review of University of Tokyo Hospital experience.
abstract: BACKGROUND
  We assessed the incidence of neural complications in submandibular 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 triangle components at the University of Tokyo Hospital during the last 19 years.
  
  
  RESULTS
  The most frequent complication was mandibular branch paralysis. Excluding 12 patients with malignant tumors, facial weakness was present postoperatively in 29.8% (37) or 124 resections. All palsies subsequently resolved. The paralysis was more frequent when nerve identification was performed than when it was not.
  
  
  CONCLUSIONS
  The cardinal factors in minimizing incidence of nerve damage are an understanding 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.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, University of Tokyo. Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ichimura
authors.forename: K
authors.initials: K
authors.lastname: Nibu
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005158:Facial Paralysis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve; D015994:Incidence; D007564:Japan; D008036:Lingual Nerve; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013363:Submandibular Gland / Q000473:pathology / Q000601:surgery*