Foreign Accent Syndrome: A Rare Sequelae after Orthognathic Surgery

Abstract

Background: Foreign accent syndrome is a rare speech disorder in which patients develop a sudden change in accent (eg, from American English to British accent) secondary to neurogenic, psychogenic, structural, or mixed causes. Orthognathic surgery may produce alterations in speech in select patients. Until now, foreign accent syndrome has not been noted after orthognathic surgery. Methods: A retrospective study of patients who underwent orthognathic surgery and developed foreign accent syndrome was conducted to document surgical details, postoperative course, speech evaluations, perioperative imaging and follow-up outcome (n = 5). Results: Patients who developed FAS after orthognathic procedures had an age range of 19 to 42 years and changed speech from American English to a British accent almost immediately in the postoperative period. There were no perioperative complications. Speech therapy revealed similar speech patterns and articulation changes. Patients found speech therapy helpful and all but 1 patient had resolution of their FAS speech within 2 years. Conclusion: Foreign Accent Syndrome is very rare but may result after orthognathic surgery when presumably a minor neurologic insult from temporary brain ischemia occurs during surgery. However, this phenomenon typically resolves and speech therapy may be helpful.