Suga Yuri, Habe Kazutoshi, Kawasaki Takashi, Sata Takeyoshi
Masui. 2016 Oct;65(10):1048-1050.
A 46-year-old woman with cervical disc herniation underwent C4-6 laminoplasty and C4-5 foraminotomy under general anesthesia. The patient complained of the tongue deviation toward the right after surgery. She underwent several examinations and was diag- nosed as right hypoglossal nerve palsy caused by peripheral nerve disorder. It was considered that the main damage was the external branch of hypoglossal nerve which was likely to occur as a complication of compression because of the location. The cause of hypoglossal nerve palsy was assumed to be possibly direct compression of the hypoglossal nerve by the tracheal tube. In prone position surgery, it is important to take care of pressure to the tongue because the intraoral space tends to be reduced by edema of the face and neck.
一名46岁患有颈椎间盘突出症的女性在全身麻醉下接受了C4-6椎板成形术和C4-5椎间孔切开术。患者术后抱怨舌头向右偏斜。她接受了多项检查,被诊断为外周神经疾病导致的右侧舌下神经麻痹。据认为,主要损伤是舌下神经的外支,由于其位置关系,这种损伤很可能是压迫并发症。舌下神经麻痹的原因推测可能是气管导管直接压迫舌下神经。在俯卧位手术中,由于面部和颈部水肿会使口腔内空间变小,因此注意对舌头的压力很重要。