Isolated Bilateral Paralysis of the Hypoglossal Nerve after Transoral Intubation for General Anesthesia

Rubio-Nazabal, Eduardo; Marey-López, José; López-Facal, Soledad; Alvarez-Perez, P.; Martinez-Figueroa, A; Corral, P. Rey del

doi:10.1097/00000542-200201000-00040

Cited by 42 publications

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“…All studies that provide laryngoscope information for orotracheal intubation report the use of a Macintosh blade, either size 3 or 4. 2,7,8,15,27,30,45,47,48,52, 54,57 Figure 3b displays the reported airway management techniques that were used in patients who subsequently developed isolated or multiple cranial nerve neurapraxia. In their review, Dziewas and Ludemann show that HNP occurs after direct laryngoscopy and endotracheal intubation, LMA placement, and even after bronchoscopy.…”

Section: Resultsmentioning

confidence: 99%

“…In 9 patients, the ETT cuff pressure was maintained < 20 cmH 2 O, 2,7,10,12,16,22,27,52 while in 1 patient, the intracuff pressure was maintained at 30 cmH 2 O before surgical draping. 10 Al-Benna described hypoglossal nerve injury in a patient with a maximum measured ETT cuff pressure of 34 cmH 2 0.…”

Section: Resultsmentioning

confidence: 99%

“…Aside from the complications associated with prolonged intubation, no studies have evaluated its relative contribution specifically to HNP. On the other hand, repeated airway management attempts, 5,29 intra- and postoperative reintubations, 6,27,28,40,57 and prolonged ventilatory support 27,35,40 increase the risk of iatrogenic trauma to the airway mucosa and underlying nerve structures. Three patients required reintubation due to respiratory failure.…”

Section: Resultsmentioning

confidence: 99%

“…Three patients required reintubation due to respiratory failure. 6,27,40 Two additional patients required LMA replacement 28 or conversion to ETT 34 for preoperative supraglottic airway device dislocation. All 5patients with bilateral isolated HNP included1 of these factors of complex airway management.…”

Section: Resultsmentioning

confidence: 99%

“…All 5patients with bilateral isolated HNP included1 of these factors of complex airway management. 6,27–29,35 …”

Section: Resultsmentioning

confidence: 99%

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Hypoglossal Nerve Palsy After Airway Management for General Anesthesia

Shah

Barnes

Spiekerman

2015

Anesthesia &Amp; Analgesia

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Isolated hypoglossal nerve palsy (HNP), or neurapraxia, a rare postoperative complication after airway management, causes ipsilateral tongue deviation, dysarthria, and dysphagia. We reviewed the pathophysiological causes of hypoglossal nerve injury and discuss the associated clinical and procedural characteristics of affected patients. Furthermore, we identified procedural factors potentially affecting HNP recovery duration and propose several measures that may reduce the risk of HNP. While HNP can occur after a variety of surgeries, most cases in the literature were reported after orthopedic and otolaryngology operations, typically in males. The diagnosis is frequently missed by the anesthesia care team in the recovery room due to the delayed symptomatic onset and often requires neurology and otolaryngology evaluations to exclude serious etiologies. Signs and symptoms are self-limited, with resolution occurring within 2 months in 50% of patients, and 80% resolving within 4 months. Currently, there are no specific preventive or therapeutic recommendations. We found 69 cases of HNP after procedural airway management reported in the literature from 1926–2013.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…All 5patients with bilateral isolated HNP included1 of these factors of complex airway management. 6,27–29,35 …”

Section: Resultsmentioning

confidence: 99%

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Hypoglossal Nerve Palsy After Airway Management for General Anesthesia

Shah

Barnes

Spiekerman

2015

Anesthesia &Amp; Analgesia

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A late recognition of tapia syndrome

Gevorgyan

Nedzelski

2013

The Laryngoscope

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Tapia syndrome is characterized by concurrent paralysis of the recurrent laryngeal and hypoglossal nerves. The mechanism is associated with airway manipulation in 70% of patients and is attributed to compression or stretching of these nerves. Diagnosis is based on recognition of the concurrent paralyses and investigations to exclude central or vascular causes. Treatment is supportive, with emphasis on empiric corticosteroids and dysphagia therapy. Recovery is excellent in 30% of patients, incomplete in 39% of patients, and none in over 26% of patients. A case of a 48-year-old woman is described, who was diagnosed with Tapia syndrome 3 years after the suspected injury.

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Physical Rehabilitation of Paralysed Facial Muscles: Functional and Morphological Correlates

Angelov

2011

Advances in Anatomy, Embryology and Cell Biology

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Reviews and critical articles covering the entire field of normal anatomy (cytology, histology, cyto-and histochemistry, electron microscopy, macroscopy, experimental morphology and embryology and comparative anatomy) are published in Advancesin Anatomy, Embryology and Cell Biology. Papers dealing with anthropology and clinical morphology that aim to encourage cooperation between anatomy andrelated disciplines will also be accepted. Papers are normally commissioned. Original papers and communications may be submitted and will be considered for publication provided they meet the requirements of a review article and thus fit into the scope of "Advances". English language is preferred. It is a fundamental condition that submitted manuscripts have not been and will not simultaneously be submitted or published elsewhere. With the acceptance of a manuscript for publication, the publisher acquires full and exclusive copyright for all languages and countries.

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Isolated Bilateral Paralysis of the Hypoglossal Nerve after Transoral Intubation for General Anesthesia

Cited by 42 publications

References 0 publications

Hypoglossal Nerve Palsy After Airway Management for General Anesthesia

Hypoglossal Nerve Palsy After Airway Management for General Anesthesia

A late recognition of tapia syndrome

Physical Rehabilitation of Paralysed Facial Muscles: Functional and Morphological Correlates

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