Paresia transitória unilateral combinada do nervo hipoglosso e do nervo lingual após intubação para anestesia

Abstract

Nerve damage may occur in the pharyngolaryngeal region during general anesthesia. The most frequently injured nerves are the hypoglossal, lingual and recurrent laryngeal. These injuries may arise in association with several factors, such as laryngoscopy, endotracheal intubation and tube insertion, cuff pressure, mask ventilation, the triple airway maneuver, the oropharyngeal airway, manner of intubation tube insertion, head and neck position and aspiration. Nerve injuries in this region may take the form of an isolated single nerve or of paresis of two nerves together in the form of hypoglossal and recurrent laryngeal nerve palsy (Tapia's syndrome). However, combined injury of the lingual and hypoglossal nerves following intubation anesthesia is a much rarer condition. The risk of this damage can be reduced with precautionary measures. We describe a case of combined unilateral nervus hypoglossus and nervus lingualis paresis developing after intubation anesthesia.

Incidence and risk factors for postoperative lingual neuropraxia following airway instrumentation: A retrospective matched case-control study

“…Lingual nerve injury or neuropraxia is a rare but potentially serious perioperative complication following airway manipulation [ 1 ], particularly in patients received supraglottic airway instrumentation [ 2 ] or endotracheal intubation [ 3 ] during general anesthesia. Lingual nerve injury commonly presents with unilateral or bilateral tongue numbness and altered taste perception [ 4 ].…”

“…It is vulnerable to compression and stretching by laryngeal mask airways (LMA), endotracheal tube general anesthesia (ETGA), and other devices situated on the base of the tongue and inner surface of the mandible close to the third molar [ 9 ]. Patients who received supraglottic airway instrumentation [ 2 ] or endotracheal intubation [ 3 ] during general anesthesia are particularly at risk. Case-series studies and case reports also suggest that patient-related (such as diabetes, peripheral vascular disease), anesthesia-related (such as the size and placement of airway devices, cuff pressure, and poor technique) and surgical-related (patient positioning, head rotation, prolonged operation time) risk factors might have contributed to the development of postoperative lingual nerve injury [ 9 ], but the exact incidence and risk factors for postanesthesia lingual neuropraxia are still undetermined [ 2 , 9 ].…”

An uncommon complication: Isolated unilateral hypoglossal nerve palsy after septorhinoplasty

“…Genel anestezi sonrası boğaz ağrısı, boğazda kuruluk hisssi, yutma güçlüğü, uvula ödemi, konuşma güçlüğü ve orofarengeal ülserasyonlar erken dönemde görülen ve genellikle izlemle düzelen nonspesifik komplikasyonlardır. Bunlara ek olarak, lingual sinir, hipoglossal sinir ve reküren laringeal sinir paralizi ve parezileri de erken dönemde nadir olsa da görülebilen, fakat oluştuğunda hem hasta hem de hekim açısından sıkıntılı süreç yaşatan önemli komplikasyonlardandır (1).…”