From the Department of Anesthesiology, Tufts Medicine, Boston, Massachusetts.
Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts.
A A Pract. 2024 Sep 9;18(9):e01849. doi: 10.1213/XAA.0000000000001849. eCollection 2024 Sep 1.
Dysphagia after anterior cervical spine surgery has a 5% to 15% incidence beyond 1-year postsurgery, often attributed to mechanical factors such as pharyngeal thickening and epiglottis inversion. Despite normal neurological examination and electromyography, nerve distortion related to stretching also remains a possibility in these patients and may cause allodynia resulting in odynophagia and dysphagia. Current treatment options for dysphagia after anterior cervical discectomy and fusion are limited to local intraoperative steroid injections and tracheal traction exercises. In our patient, a glossopharyngeal nerve block was effectively used to manage the glossopharyngeal allodynia, thereby reducing the odynophagia and dysphagia, ultimately enhancing oral tolerance.
颈椎前路手术后吞咽困难的发生率为术后 1 年 5%~15%，常归因于机械因素，如咽壁增厚和会厌翻转。尽管神经学检查和肌电图正常，但这些患者仍有可能存在与拉伸相关的神经扭曲，这可能导致感觉异常，从而导致吞咽疼痛和吞咽困难。颈椎前路椎间盘切除融合术后吞咽困难的治疗选择有限，仅限于术中局部类固醇注射和气管牵引练习。在我们的患者中，通过有效地使用舌咽神经阻滞来治疗舌咽神经感觉异常，从而减轻吞咽疼痛和吞咽困难，最终提高了口服耐受性。
