Incidence of dysphagia and dysphonia after Hangman's fractures: Evidence from 93 patients

This research aims to explore the accurate incidence, severity and outcomes of dysphagia and dysphonia after Hangman fractures. A total of 93 patients were included in this study and clinical data were reviewed. The Bazaz grading system (0-None; 1-Mild; 2-Moderate; 3-Severe) was used for dysphagia evaluation and the Voice Handicap Index-10 used to evaluate dysphonia. In all of the patients, evaluation of dysphagia and dysphonia was performed preoperatively and at 1 week, 1 month, 3, 6, and 12 months after surgery. SPSS 22.0 software (SPSS Inc, Chicago, IL) was used for all statistical analyses. Posttraumatic immediate dysphagia was found in 8 patients and posttraumatic immediate dysphonia was observed in 3 patients. The incidence of dysphagia was 22.6% at the 1st week, 16.1% at the 1st month, and 9.7% at the 3rd month of follow-up. The incidence of dysphonia was 24.5% at the 1st week, 11.3% at the 1st month, and 3.8% at the 3rd month of follow-up. Posttraumatic immediate dysphagia and dysphonia occurred and the anterior surgical approach was associated with a higher incidence of dysphagia compared to posterior surgery and nonoperative patients. Most dysphagia and dysphonia were mild and gradually decreased during the subsequent 3 months after surgery. Future prospective, randomized studies with larger sample sizes are required to validate these data.