Transient nerve damage following intubation for trans-sphenoidal hypophysectomy

Evers, K. A.; Eindhoven, G. B.; Wierda, J. M. K. H.

doi:10.1007/bf03015523

Cited by 34 publications

(21 citation statements)

References 6 publications

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“…In addition, direct pressure exerted by the Macintosh blade at the base of the tongue causes soft tissue compression against the hyoid bone, possibly exacerbating the neurapraxia. 1,3,12,15,26,30,46,49,73,74 …”

Section: Resultsmentioning

confidence: 99%

Hypoglossal Nerve Palsy After Airway Management for General Anesthesia

Shah

Barnes

Spiekerman

2015

Anesthesia &Amp; Analgesia

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Isolated hypoglossal nerve palsy (HNP), or neurapraxia, a rare postoperative complication after airway management, causes ipsilateral tongue deviation, dysarthria, and dysphagia. We reviewed the pathophysiological causes of hypoglossal nerve injury and discuss the associated clinical and procedural characteristics of affected patients. Furthermore, we identified procedural factors potentially affecting HNP recovery duration and propose several measures that may reduce the risk of HNP. While HNP can occur after a variety of surgeries, most cases in the literature were reported after orthopedic and otolaryngology operations, typically in males. The diagnosis is frequently missed by the anesthesia care team in the recovery room due to the delayed symptomatic onset and often requires neurology and otolaryngology evaluations to exclude serious etiologies. Signs and symptoms are self-limited, with resolution occurring within 2 months in 50% of patients, and 80% resolving within 4 months. Currently, there are no specific preventive or therapeutic recommendations. We found 69 cases of HNP after procedural airway management reported in the literature from 1926–2013.

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Section: Resultsmentioning

confidence: 99%

Hypoglossal Nerve Palsy After Airway Management for General Anesthesia

Shah

Barnes

Spiekerman

2015

Anesthesia &Amp; Analgesia

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“…axonotmesis or neurotmesis). Additionally, Evers et al [14]pointed out that the risk of distension of the nerve during intubation is increased, if pressure is applied to the cricoid resulting in immobilization of the nerve.…”

Section: Discussionmentioning

confidence: 99%

“…There are only a few case reports published in anesthesiologic or otorhino-laryngological but not neurological journals, referring to hypoglossal nerve palsies following intubation, use of the laryngeal mask airway (LMA) or bronchoscopy [8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25]. These palsies are usually diagnosed by a consulted neurologist, asked for the underlying etiology, prognosis and treatment options.…”

Section: Introductionmentioning

confidence: 99%

Hypoglossal Nerve Palsy as Complication of Oral Intubation, Bronchoscopy and Use of the Laryngeal Mask Airway

Dziewas¹,

Lüdemann²

2002

Eur Neurol

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Hypoglossal nerve injury is a recognized but rare complication of oropharyngeal manipulation during intubation, bronchoscopy and use of a laryngeal mask airway. We present 2 new cases of temporary hypoglossal nerve palsy after orotracheal intubation for general anesthesia. The relevant literature is reviewed and different hypotheses concerning the pathophysiological mechanisms of nerve damage are discussed.

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“…3 Pressure on the cricoid cartilage during the process of intubation also is described as a cause of traction on the hypoglossal nerve as it is fixed to the area of the cricoid cartilage. 4 Some combined arthroscopic and open procedures require an intraoperative change in the trunk flexion angle of the patient placed in the beach-chair position from 70 during arthroscopy to 30 when converting to an open surgery. This was the case in both of our patients.…”

Section: Discussionmentioning

confidence: 99%