Joshi Minal, Cheng Ruth, Kamath Hattiyangadi, Yarmush Joel
Department of Anesthesiology, New York Methodist Hospital, New York, NY, USA.
School of Medicine, St. George's University, Grenada, West Indies.
Local Reg Anesth. 2017 Jul 20;10:75-77. doi: 10.2147/LRA.S138998. eCollection 2017.
Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position. The GAN, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. We recommend that for the procedures of 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.
肩关节镜检查已被证明是许多诊断和治疗干预的首选方法。耳大神经（GAN）神经失用是肩部手术的一种罕见并发症，患者处于沙滩椅位。我们报告一例与马蹄形头枕直接压迫相关的耳大神经失用病例，该头枕用于简单肩部手术的常规体位摆放。在本病例中，采用关节镜入路，于沙滩椅位在区域麻醉加镇静下进行手术。耳大神经是颈丛的一个浅支，因其表浅的解剖位置而易发生神经失用。我们建议，对于沙滩椅位手术，应使用棉花和纱布保护并覆盖耳廓，以避免直接压迫，并应经常检查和纠正头颈部位置。
