M. Güven GÜVENÇ, A. Sanem ÖZATA, Türker ŞENGÜL, Sibel ŞENER

ENTÜBASYON SONRASI MEYDANA GELEN TEK TARAFLI HİPOGLOSSUS FELCİ

Bazı nörolojik hastalıklar, malign tümörler, travma ve cerrahi hipoglossus felcine yol açabilir. Buna karşın entübasyon sonrası XII. sinir felci meydana gelmesi nadirdir. Bu yazıda burun ve sağ falanks kırığı nedeniyle opere olan 40 yaşında bir kadın hasta sunulmuştur. Hastada ameliyat sonrası birinci günde sol hipoglossus felci tespit edildi. Hastanın nörolojik muayenesinde ve Kulak Burun Boğaz muayenesinde herhangi başka bir patoloji tespit edilmedi. Sinir felci ameliyat sonrası 6. haftada tamamen ortadan kalktı. Entübasyon sonrası hipoglossus felci çok nadirdir. Uygun cuff basıncı, düzgün orotrakeal entübasyon ve cerrahi sırasında kafanın yanlış pozisyonda bırakılmaması bu komplikasyonun önlenmesi açısından önemlidir. Bu hastaların dikkatli bir nörolojik değerlendirilmeden geçirilmeleri, tam bir Kulak Burun Boğaz muayenelerinin yapılması ve takip edilmeleri büyük önem taşır. Olguların büyük kısmı sekel olmadan iyileşmektedir.

Unilateral Hypoglossus Nerve Palsy Following Intubation

Some neurological diseases, malignant tumors, trauma and surgery might cause hypoglossal nerve palsy. However XIIth nerve palsy following intubation is unusual. A 40 year-old woman underwent surgery for nasal and right phalangeal fractures. The patient had a left hypoglossal nerve palsy which was detected on the first postoperative day. Her neurological and otorhinolaryngological evaluation showed no other pathology. The palsy resolved completely in the 6th postoperative week. Post-intubation hypoglossal nerve palsy is very rare. Appropriate cuff pressure, uneventful oro-tracheal intubation, and avoiding malpositioning of the head during surgery are of considerable importance in avoiding this complication. A meticulous neurologic and otorhinolaryngologic evaluation and follow-up of these patients is critical. The majority of cases recover without sequela.

Keywords:

unilateral hypoglossal palsy, intubation,

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