Anesth Pain Med.  2016 Apr;11(2):220-223. 10.17085/apm.2016.11.2.220.

Unilateral hypoglossal nerve palsy after endotracheal intubation for general anesthesia in a difficult airway patient: A case report

• Lee SJ
• Ryu CH
• Kwon KH
• Kim NW
• Jeong HJ

• KMID: 2358490
• DOI: http://doi.org/10.17085/apm.2016.11.2.220

Abstract

Hypoglossal nerve palsy after general anesthesia is an exceptionally rare complication, which has varied etiology. We present a case of unilateral hypoglossal nerve palsy resulting from repeated airway intervention for general anesthesia. A 57-year-old woman was scheduled to undergo modified radical mastectomy. During endotracheal intubation, the patient had Cormack's grade III-a severe airway condition. After the first intubation attempt failed, the intubation was attempted a second time using a stylet inside the endotracheal tube with cricoid pressure; this attempt was successful. In the evening of the operation day, the patient complained of dysarthria and dysphagia. Physical examination revealed deviation of the tongue to the right, which may have been caused by traumatic hypoglossal nerve injury. This case reviews the pathophysiology, prevention, and management of hypoglossal nerve palsy.

Keyword

Endotracheal intubation; General anesthesia; Hypoglossal nerve; Palsy

MeSH Terms

Anesthesia, General*
Deglutition Disorders
Dysarthria
Female
Humans
Hypoglossal Nerve Diseases*
Hypoglossal Nerve Injuries
Hypoglossal Nerve*
Intubation
Intubation, Intratracheal*
Mastectomy, Modified Radical
Middle Aged
Paralysis
Physical Examination
Tongue

Figure

• 

  Fig. 1 A coronal view of the computed tomography scan. Interstitial swelling of the right side of the base of the tongue is observed.

• 

  Fig. 2 Mobile tongue deviation to the right side.

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