[Hypoglossal nerve paralysis after endonasal paranasal sinus operation in intubation narcosis].

BACKGROUND

In the literature the possibility of a pressure trauma to the hypoglossal nerve between the root of the tongue and the ligamentum stylohyoideum is discussed. A recent in vivo study examined the effects of forced reclination of the head on the nerve.

PATIENT

A left sided hypoglossal nerve paralysis occurred in a patient after an endoscopically controlled endonasal operation under general anesthesia with transoral intubation.

RESULTS

Clinically and electrophysiologically the palsy seemed to be transient due to neurapraxia. An X-ray of the neck performed after the operation revealed a calcification of the left ligamentum stylohyoideum. All the other diagnostic studies (ultrasound of the neck, neurological examination, serological tests, and CT scan of the head) did not show any abnormalities. This is the first time, that a postoperative hypoglossal nerve palsy has been observed, which could not be explained by extensive stretching or pressure.

CONCLUSION

We believe that the short pressure of the Mcintosh spatula produced the hypoglossal nerve palsy described.