Cranial nerve XII (hypoglossal nerve) palsy after arthroscopic shoulder surgery under general anesthesia combined with sono-guided interscalene brachial plexus block -A case report-

Kim, Chang Jae; Oh, Hyun Seok; Park, Jun-Jae; Chung, Mee Young

doi:10.17085/apm.2016.11.3.322

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…While positioned in the beach chair position, a head strap is used to secure the head in a neutral position. Placing the strap too tightly at the angle of the mandible or manipulation during surgery, can cause direct compression or hyperextension to the hypoglossal nerve [50]. It is plausible that while wanting to secure the head in a secure neutral position, overzealous tightening of the head strap and direct compression of the hypoglossal nerve could cause injury.…”

Section: Discussionmentioning

confidence: 99%

Tongue Tied after Shoulder Surgery: A Case Series and Literature Review

Kraus

Cain

Rosenfeld

et al. 2019

Case Reports in Anesthesiology

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This article presents three cases of cranial nerve palsy following shoulder surgery with general anesthesia in the beach chair position. All patients underwent preoperative ultrasound-guided interscalene nerve block. Two cases of postoperative hypoglossal and one case of combined hypoglossal and recurrent laryngeal nerve palsies (Tapia's syndrome) were identified. Through this case series, we provide a literature review identifying postoperative cranial nerve palsies in addition to the discussion of possible etiologies. We suggest that intraoperative patient positioning and/or airway instrumentation is most likely causative. We conclude that the beach chair position is a risk factor for postoperative hypoglossal nerve palsy and Tapia's syndrome.

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Section: Discussionmentioning

confidence: 99%

Tongue Tied after Shoulder Surgery: A Case Series and Literature Review

Kraus

Cain

Rosenfeld

et al. 2019

Case Reports in Anesthesiology

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“…While the exact mechanism is unknown, either compression or distraction of the nerve may be involved. 50 51 52 53 54 Eight cases of neurapraxia of the greater auricular nerve have been reported in the literature after shoulder surgery in the BC position, and direct nerve compression by the headrest was considered to be the etiology. 55 56 57 58…”

Section: Beach Chair Positionmentioning

confidence: 99%

Patient Positioning in Shoulder Arthroscopy: Which is Best?

Rojas

Familiari²,

Bitzer

et al. 2019

Joints

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When performing diagnostic and surgical arthroscopic procedures on the shoulder, the importance of patient positioning cannot be understated. The optimum patient positioning for shoulder arthroscopy should enhance intraoperative joint visualization and surgical accessibility while minimizing potential perioperative risk to the patient. Most shoulder arthroscopy procedures can be reliably performed with the patient either in the lateral decubitus (LD) or beach chair (BC) position. Although patient positioning for shoulder arthroscopy has been subject of controversy, there is no conclusive evidence to suggest superiority of one position versus another. Each position offers advantages and disadvantages and surgeon's experience and training are pivotal on selecting one position versus another. Regardless of the position, a proper positioning of the patient should provide adequate access to the joint while minimizing complications. The purpose of this review is to summarize setup and technical aspects, the advantages and disadvantages, and the possible complications of the LD and BC positions in shoulder arthroscopy.

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