Brattou Panagiota, Iliakopoulos Konstantinos, Anagnostou Evangelos, Zambelis Thomas, Polydorou Andreas, Theodoraki Kassiani
Department of Anesthesiology, Aretaieion University Hospital, National and Kapodistrian University of Athens, Greece.
Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Greece.
Int J Surg Case Rep. 2022 Jul;96:107387. doi: 10.1016/j.ijscr.2022.107387. Epub 2022 Jul 5.
Hypoglossal nerve palsy is a rare condition usually associated with tumors, trauma, stroke or multiple sclerosis. It can be associated with other cranial nerve palsies while injury to this nerve typically affects a patient's articulation by causing lingual motility disturbance and swallowing difficulty. Bilateral isolated hypoglossal nerve palsy is an even more infrequent condition, which can occasionally be due to airway manipulation.
We describe a case of bilateral hypoglossal nerve damage following general anesthesia for emergency surgery, presenting with dysarthria, immobility of the tongue and dysphagia after extubation. The patient had a gradual recovery of all lost functions during the next four months.
Bilateral hypoglossal nerve palsy is a very rare entity and tracheal tube malposition or prolonged but unnoticed tracheal cuff pressure especially in the face of low blood pressure, should be considered as possible causative mechanisms for this condition. This underlines the importance of careful positioning of the patient's head and neck during surgery as well as the meticulous and correct performance of routine maneuvers of airway management.
Bilateral hypoglossal nerve palsy is a very rare entity. Diagnosis and management of twelfth nerve palsy require a multidisciplinary approach to achieve the best patient outcome.
舌下神经麻痹是一种罕见病症，通常与肿瘤、创伤、中风或多发性硬化症相关。它可能与其他颅神经麻痹同时出现，而该神经损伤通常会因导致舌运动障碍和吞咽困难而影响患者的发音。双侧孤立性舌下神经麻痹更为罕见，偶尔可能是由于气道操作引起。
我们描述了一例急诊手术全身麻醉后双侧舌下神经损伤的病例，患者拔管后出现构音障碍、舌活动障碍和吞咽困难。在接下来的四个月里，患者所有丧失的功能逐渐恢复。
双侧舌下神经麻痹是一种非常罕见的情况，气管导管位置不当或气管套囊压力持续时间过长但未被注意到，尤其是在低血压情况下，应被视为导致这种情况的可能原因。这强调了手术期间患者头颈部仔细定位以及气道管理常规操作细致正确执行的重要性。
双侧舌下神经麻痹是一种非常罕见的情况。第十二对脑神经麻痹的诊断和管理需要多学科方法以实现最佳患者预后。
