Yasuda Tatsuya, Togawa Daisuke, Hasegawa Tomohiko, Yamato Yu, Kobayashi Sho, Arima Hideyuki, Matsuyama Yukihiro
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Asian Spine J. 2015 Apr;9(2):295-8. doi: 10.4184/asj.2015.9.2.295. Epub 2015 Apr 15.
A recurrent laryngeal nerve injury is known as a complication referring to an anterior cervical spine surgery. However, hypoglossal nerve injury is not well known yet. Herein we report a rare case of a 39-years-old male with a hypoglossal nerve injury after C3/4 osteophyte resection with Smith-Robinson approach. In this case there appeared difficulties of articulation and tongue movement with deviation of the tongue to the left side after the surgery and we diagnosed a hypoglossal nerve injury due to retraction against the nerve during the operation. During the operative approach to the upper cervical spine we had to retract the internal carotid artery and the soft tissue to reach the vertebrae. This retract was the cause of the hypoglossal nerve injury. A gently traction and intermittent release is important to avoid a hypoglossal nerve damage.
喉返神经损伤是颈椎前路手术已知的一种并发症。然而，舌下神经损伤尚未广为人知。在此，我们报告一例罕见病例，一名39岁男性在采用史密斯-罗宾逊入路行C3/4骨赘切除术后发生舌下神经损伤。该病例术后出现发音和舌运动困难，舌向左侧偏斜，我们诊断为手术过程中对神经的牵拉导致舌下神经损伤。在上颈椎手术入路过程中，我们不得不牵拉颈内动脉和软组织以暴露椎体。这种牵拉是舌下神经损伤的原因。轻柔牵拉和间歇性松解对于避免舌下神经损伤很重要。
