Park Tae-Soo, Kim Yee-Suk
Department of Orthopaedic Surgery, Kuri Hospital, Hanyang University College of Medicine, Kuri-City, Korea.
Arthroscopy. 2005 May;21(5):631. doi: 10.1016/j.arthro.2005.02.003.
This article presents uncommon cases of neuropraxia of the lesser occipital nerve and the greater auricular nerve after arthroscopic surgery of the shoulder in the beach-chair position under general anesthesia. The lesser occipital nerve and the greater auricular nerve are superficial ascending branches of the cervical plexus. These 2 superficial nerves may be easily vulnerable because of their superficial anatomic locations. We assumed that the severity of the neuropraxia of superficial branches of the cervical plexus was related to the degree of rotation and deviation of the head and neck, the duration of the procedure, and compression by head strap and elastic bandage used for fixing the head to the rectangular-shaped headrest of the beach-chair device. We recommend that during surgery in the beach-chair position, the auricle be protected and covered with cotton and gauze to avoid direct compression and the position of the head and neck be checked and corrected frequently. We hope for a new design of the headrest of the beach-chair device to prevent neuropraxia and to attach the head firmly and safely.
本文介绍了在全身麻醉下沙滩椅位进行肩关节关节镜手术后枕小神经和耳大神经发生神经失用症的罕见病例。枕小神经和耳大神经是颈丛的浅支上升分支。这两条浅表神经因其浅表的解剖位置而容易受到损伤。我们认为，颈丛浅表分支神经失用症的严重程度与头颈部的旋转和偏斜程度、手术持续时间以及用于将头部固定在沙滩椅装置矩形头枕上的头带和弹性绷带的压迫有关。我们建议在沙滩椅位手术期间，用棉花和纱布保护并覆盖耳廓，以避免直接压迫，并经常检查和纠正头颈部的位置。我们希望对沙滩椅装置的头枕进行新的设计，以预防神经失用症，并牢固、安全地固定头部。
