Öz
Some neurological diseases, malignant tumors, trauma and surgery might cause hypoglossal nerve palsy. However XIIth nerve palsy following intubation is unusual. A 40 year-old woman underwent surgery for nasal and right phalangeal fractures. The patient had a left hypoglossal nerve palsy which was detected on the first postoperative day. Her neurological and otorhinolaryngological evaluation showed no other pathology. The palsy resolved completely in the 6th postoperative week. Post-intubation hypoglossal nerve palsy is very rare. Appropriate cuff pressure, uneventful oro-tracheal intubation, and avoiding malpositioning of the head during surgery are of considerable importance in avoiding this complication. A meticulous neurologic and otorhinolaryngologic evaluation and follow-up of these patients is critical. The majority of cases recover without sequela.
Anahtar Kelimeler
Kaynakça
- Uña E, Gandía F, Duque JL. Tongue paralysis after orotracheal intubation in a patient with primary mediastinal tumor: a case report. Cases J. 2009;2:9301.
- Divatia JV, Bhowmick K. Complications of endotracheal intubation and other airway management procedures. Indian J. Anaesth 2005;49:308-18.
- Tesei F, Poveda LM, Strali W, Tosi L, Magnani G, Farneti G. Unilateral laryngeal and hypoglossal paralysis (Tapia’s syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. Acta Otorhinolaryngol Ital 2006;26:219-21.
- Nuutinen J, Kärjä J. Bilateral vocal cord paralysis following general anesthesia. Laryngoscope 1981;91:83-6.
- Dullenkopf A, Gerber AC, Weiss M. Nitrous oxide diffusion into tracheal tube cuffs: comparison of five different tracheal tube cuffs. Acta Anaesthesiol Scand 2004;48:1180-4.
- Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed) 1984;288:965-8.
- Sengupta P, Sessler DI, Maglinger P, Wells S, Vogt A, Durrani J, Wadhwa A. Endotracheal tube cuff pressure in three hospitals, and the volume required to produce an appropriate cuff pressure. BMC Anesthesiol 2004;4:8.
- Boisseau N, Rabarijaona H, Grimaud D, Raucoules-Aimé M. Tapia’s syndrome following shoulder surgery. Br J Anaesth 2002; 88:869-70.
- Kashyap SA, Patterson AR, Loukota RA, Kelly G. Tapia’s syndrome after repair of a fractured mandible. Br J Oral Maxillofac Surg 2010;48:53-4.
- Johnson TM, Moore HJ. Cranial nerve X and XII paralysis (Tapia’s syndrome) after an interscalene brachial plexus block for a left shoulder Mumford procedure. Anesthesiology 1999;90:311-2.
- de Freitas MR, Nascimento OJ, Chimelli L. Tapia’s syndrome caused by Paracoccidioidis brasiliensis. J Neurol Sci 1991;103:179-81.
- Andrioli G, Rigobello L, Mingrino S, Toso V. Tapia’s syndrome caused by a neurofibroma of the hypoglossal and vagus nerves: case report. J Neurosurg 1980;52:730-2.
- Rotondo F, De Paulis S, Modoni A, Schiavello R. Peripheral Tapia’s syndrome after cardiac surgery. Eur J Anaesthesiol 2010;27:575-6.
Öz
Bazı nörolojik hastalıklar, malign tümörler, travma ve cerrahi hipoglossus felcine yol açabilir. Buna karşın entübasyon sonrası XII. sinir felci meydana gelmesi nadirdir. Bu yazıda burun ve sağ falanks kırığı nedeniyle opere olan 40 yaşında bir kadın hasta sunulmuştur. Hastada ameliyat sonrası birinci günde sol hipoglossus felci tespit edildi. Hastanın nörolojik muayenesinde ve Kulak Burun Boğaz muayenesinde herhangi başka bir patoloji tespit edilmedi. Sinir felci ameliyat sonrası 6. haftada tamamen ortadan kalktı. Entübasyon sonrası hipoglossus felci çok nadirdir. Uygun cuff basıncı, düzgün orotrakeal entübasyon ve cerrahi sırasında kafanın yanlış pozisyonda bırakılmaması bu komplikasyonun önlenmesi açısından önemlidir. Bu hastaların dikkatli bir nörolojik değerlendirilmeden geçirilmeleri, tam bir Kulak Burun Boğaz muayenelerinin yapılması ve takip edilmeleri büyük önem taşır. Olguların büyük kısmı sekel olmadan iyileşmektedir.
Anahtar Kelimeler
Kaynakça
- Uña E, Gandía F, Duque JL. Tongue paralysis after orotracheal intubation in a patient with primary mediastinal tumor: a case report. Cases J. 2009;2:9301.
- Divatia JV, Bhowmick K. Complications of endotracheal intubation and other airway management procedures. Indian J. Anaesth 2005;49:308-18.
- Tesei F, Poveda LM, Strali W, Tosi L, Magnani G, Farneti G. Unilateral laryngeal and hypoglossal paralysis (Tapia’s syndrome) following rhinoplasty in general anaesthesia: case report and review of the literature. Acta Otorhinolaryngol Ital 2006;26:219-21.
- Nuutinen J, Kärjä J. Bilateral vocal cord paralysis following general anesthesia. Laryngoscope 1981;91:83-6.
- Dullenkopf A, Gerber AC, Weiss M. Nitrous oxide diffusion into tracheal tube cuffs: comparison of five different tracheal tube cuffs. Acta Anaesthesiol Scand 2004;48:1180-4.
- Seegobin RD, van Hasselt GL. Endotracheal cuff pressure and tracheal mucosal blood flow: endoscopic study of effects of four large volume cuffs. Br Med J (Clin Res Ed) 1984;288:965-8.
- Sengupta P, Sessler DI, Maglinger P, Wells S, Vogt A, Durrani J, Wadhwa A. Endotracheal tube cuff pressure in three hospitals, and the volume required to produce an appropriate cuff pressure. BMC Anesthesiol 2004;4:8.
- Boisseau N, Rabarijaona H, Grimaud D, Raucoules-Aimé M. Tapia’s syndrome following shoulder surgery. Br J Anaesth 2002; 88:869-70.
- Kashyap SA, Patterson AR, Loukota RA, Kelly G. Tapia’s syndrome after repair of a fractured mandible. Br J Oral Maxillofac Surg 2010;48:53-4.
- Johnson TM, Moore HJ. Cranial nerve X and XII paralysis (Tapia’s syndrome) after an interscalene brachial plexus block for a left shoulder Mumford procedure. Anesthesiology 1999;90:311-2.
- de Freitas MR, Nascimento OJ, Chimelli L. Tapia’s syndrome caused by Paracoccidioidis brasiliensis. J Neurol Sci 1991;103:179-81.
- Andrioli G, Rigobello L, Mingrino S, Toso V. Tapia’s syndrome caused by a neurofibroma of the hypoglossal and vagus nerves: case report. J Neurosurg 1980;52:730-2.
- Rotondo F, De Paulis S, Modoni A, Schiavello R. Peripheral Tapia’s syndrome after cardiac surgery. Eur J Anaesthesiol 2010;27:575-6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2016 |
| Yayımlandığı Sayı | Yıl 2016Sayı: 1 |