Department of Anesthesiology, No. 363 Hospital, Sichuan Province, Chengdu, China.
Department of Nursing, No. 363 Hospital, Sichuan Province, Chengdu, China.
J Int Med Res. 2023 Aug;51(8):3000605231190899. doi: 10.1177/03000605231190899.
Laryngeal masks are widely used by anesthesiologists in clinical practice because of their advantages of no tracheal injury, minimal airway stimulation, limited airway tissue invasion, and easy implantation and airway establishment. We herein describe a patient with congenital heart disease who developed unilateral sublingual nerve paralysis after application of a laryngeal mask airway. The patient reported perioral numbness and exhibited unclear speech and slight right deviation of the tip of the tongue after surgery. On physical examination, the patient had normal muscle strength, symmetrical frontal lines, normal occlusion, and a normal nasolabial groove. We performed head computed tomography and computed tomography angiography to rule out cerebrovascular disease, and no abnormalities were found. The patient's imaging findings and clinical symptoms suggested unilateral right sublingual nerve palsy. After active treatment, the patient's symptoms improved by 75% on the third postoperative day and by 90% on the fifth postoperative day. Despite the extremely low incidence of sublingual nerve palsy after application of a laryngeal mask airway, anesthesiologists should be aware of this complication. Although the nerve palsy can resolve spontaneously, the nerve damage may be permanent.
喉罩在临床实践中被麻醉医师广泛应用，因其具有无气管损伤、气道刺激小、气道组织侵犯有限、易于植入和建立气道等优点。我们在此描述了 1 例先天性心脏病患者，在应用喉罩后发生单侧舌下神经麻痹。术后患者诉口周麻木，出现言语不清和舌尖轻度向右偏斜。体格检查示患者肌力正常，额纹对称，咬合正常，鼻唇沟正常。我们行头部 CT 和 CT 血管造影以排除脑血管疾病，未见异常。患者的影像学表现和临床症状提示右侧舌下神经单侧麻痹。经积极治疗，患者术后第 3 天症状改善 75%，术后第 5 天症状改善 90%。尽管喉罩应用后舌下神经麻痹的发生率极低，但麻醉医师仍应意识到这种并发症。虽然神经麻痹可自行缓解，但神经损伤可能是永久性的。
