Koshika Kyotaro, Ouchi Takashi, Serita Ryohei, Koitabashi Toshiya
Department of Anesthesiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa City, Chiba, 272-8513, Japan.
Department of Intensive Care Medicine, National Research and Development Agency, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa City, Chiba, 277-8577, Japan.
JA Clin Rep. 2020 Apr 25;6(1):29. doi: 10.1186/s40981-020-00335-6.
Associated laryngeal paralysis is a clinical condition merged with other cranial nerve disorders associated with vocal cord paralysis. It is a rare complication in patients after general anesthesia. Here, we report our experience with a patient who developed associated laryngeal paralysis after oral surgery.
A healthy 31-year-old man underwent extraction of horizontally impacted wisdom teeth in the bilateral mandible under general anesthesia. During the surgery, no significant changes in respiratory and cardiovascular parameters or neurosurgical abnormalities occurred. After the surgery, the patient was diagnosed with aspiration pneumonia. Furthermore, the results of otorhinolaryngological and neurological examinations led to a diagnosis of a combination of bilateral glossopharyngeal and vagus nerve paralysis, right recurrent nerve paralysis, and right hypoglossal nerve paralysis. In this case, seriously associated peripheral laryngeal paralysis with repeated episodes of aspiration pneumonia improved in approximately 6 months with rehabilitation and vitamin B12 administration, and no complications remained.
We suggest that the anesthesiologist should take care of each procedure minutely. It is important to diagnose cases of nerve palsy as soon as possible to reduce the damage. Having had experience with this case, we believe sharing our experience with anesthesiologists is important.
相关性喉麻痹是一种与声带麻痹相关的其他颅神经疾病合并存在的临床病症。它是全身麻醉后患者中罕见的并发症。在此，我们报告一例口腔手术后发生相关性喉麻痹患者的诊疗经验。
一名31岁健康男性在全身麻醉下接受双侧下颌水平阻生智齿拔除术。手术过程中，呼吸和心血管参数无明显变化，也未出现神经外科异常情况。术后，患者被诊断为吸入性肺炎。此外，耳鼻喉科和神经科检查结果显示患者合并双侧舌咽神经和迷走神经麻痹、右侧喉返神经麻痹以及右侧舌下神经麻痹。在本病例中，严重的相关性周围性喉麻痹伴反复发生的吸入性肺炎，经康复治疗及给予维生素B12后，约6个月病情好转，且未遗留并发症。
我们建议麻醉医生应细致处理每一个步骤。尽早诊断神经麻痹病例以减少损害很重要。有了该病例的经验，我们认为与麻醉医生分享我们的经验很重要。
