Hanumanthaiah Deepak, Masud Sarmad, Ranganath Anil
Department of Anaesthesia, Cork University Hospital, Cork, Ireland.
J Med Case Rep. 2011 Mar 29;5:122. doi: 10.1186/1752-1947-5-122.
The incidence of damage to the individual cranial nerves and their branches associated with laryngeal mask airway use is low; there have been case reports of damage to the lingual nerve, hypoglossal nerve and recurrent laryngeal nerve. To the best of our knowledge we present the first reported case of inferior alveolar nerve injury associated with laryngeal mask airway use.
A 35-year-old Caucasian man presented to our facility for elective anterior cruciate ligament repair. He had no background history of any significant medical problems. He opted for general anesthesia over a regional technique. He was induced with fentanyl and propofol and a size 4 laryngeal mask airway was inserted without any problems. His head was in a neutral position during the surgery. After surgery in the recovery room, he complained of numbness in his lower lip. He also developed extensive scabbing of the lower lip on the second day after surgery. The numbness and scabbing started improving after a week, with complete recovery after two weeks.
We report the first case of vascular occlusion and injury to the inferior alveolar nerve, causing scabbing and numbness of the lower lip, resulting from laryngeal mask airway use. This is an original case report mostly of interest for anesthetists who use the laryngeal mask airway in day-to-day practice. Excessive inflation of the laryngeal mask airway cuff could have led to this complication. Despite the low incidence of cranial nerve injury associated with the use of the laryngeal mask airway, vigilant adherence to evidence-based medicine techniques and recommendations from the manufacturer's instructions can prevent such complications.
与喉罩气道使用相关的单个颅神经及其分支受损的发生率较低；已有舌神经、舌下神经和喉返神经受损的病例报告。据我们所知，我们首次报告了与喉罩气道使用相关的下牙槽神经损伤病例。
一名35岁的白种男性到我们机构进行择期前交叉韧带修复手术。他没有任何重大疾病的背景病史。他选择全身麻醉而非区域麻醉技术。使用芬太尼和丙泊酚诱导麻醉，顺利插入4号喉罩气道。手术过程中他的头部处于中立位。术后在恢复室，他主诉下唇麻木。术后第二天，他的下唇还出现了大面积结痂。一周后麻木和结痂开始改善，两周后完全恢复。
我们报告了首例因使用喉罩气道导致下牙槽神经血管闭塞和损伤，引起下唇结痂和麻木的病例。这是一篇原创病例报告，主要供日常使用喉罩气道的麻醉医生参考。喉罩气道套囊过度充气可能导致了这一并发症。尽管与喉罩气道使用相关的颅神经损伤发生率较低，但严格遵循循证医学技术和制造商说明书中的建议可预防此类并发症。
