Unilateral Recurrent Laryngeal and Hypoglossal Nerve Paralysis Following Rhinoplasty: A Case Report and review of Articles

Document Type: Case Report

Authors

1 Sinus and Surgical Endoscopic Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Cardiac Anesthesia Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Departments of Neurology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Departments of Otorhinolaryngology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
Injury to cranial nerves IX, X, and XII is a known complication of laryngoscopy and intubation. Here we present a patient with concurrent hypoglossal and recurrent laryngeal nerve paralysis after rhinoplasty.
Case Report:
The patient was a 27-year-old woman who was candidate for rhinoplastic surgery. The next morning after the operation, the patient complained of dysphonia and a sore throat .7 days after the operation she was still complaining of dysphonia. She underwent a direct laryngoscopy, and right TVC paralysis was observed. Right hypoglossal nerve paralysis was also detected during physical cranial nerve function tests. Hypoglossal and recurrent laryngeal nerve function was completely recovered after 5 and 7 months, respectively, and no complication was remained.
Conclusion:
Accurate and atraumatic intubation and extubation, true positioning of the head and neck, delicate and gentle packing of the oropharynx, and maintenance of mean blood pressure at a safe level are appropriate methods to prevent this complication during anesthesia and surgical procedures.

Keywords


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