Abstract
Background: Park-bench position is a commonly used position in patients operated with cerebellopontine tumor, microvascular decompression, or lesions of cerebellar hemisphere and vertebral artery. Several complications associated with this positioning have been described. However, the delayed airway complication resulting from park-bench position has been rarely reported in the literatures. Herein, we report a rare case of delayed airway obstruction after a posterior-fossa craniotomy with park-bench position for acoustic neuroma. Case Presentation: A 43-year-old woman, who has a right acoustic neuroma, was placed in the park-bench position for a posterior-fossa craniotomy. The anesthesia and operation were performed smoothly. However, progressive swelling in the left neck with extending to left face occurred two hours after endo-tracheal extubation. Computed tomographic scan of neck revealed diffuse swelling of the muscles and deep soft tissue in the left side. No obvious embolization of vascular system including jugular vein was found in the sonography. Because of obstruction in upper airway, orotracheal intubation and a head-up position were performed. The clinical symptoms improved gradually since the third post-operative day. She was discharged with obvious complications on the 23rd day after the operation. Conclusion: The possible mechanisms may originate from the kinking of the jugular vein due to hyper-flexed neck position during surgery. To prevent such complication, we must take great care of the anesthetized patients when placed in the forced neck position and always keep this rare but so critical complication in mind.
Highlights
Park-bench position is a very common posture for posterior fossa craniotomy in management of patients with cerebellopontine tumor, lesions of cerebellar hemisphere or vascular diseases
We report a rare case of delayed airway obstruction after a posterior-fossa craniotomy with park-bench position for acoustic neuroma
Delayed airway obstruction related to park-bench position after posterior fossa surgery has been rarely reported in the literatures
Summary
Park-bench position is a very common posture for posterior fossa craniotomy in management of patients with cerebellopontine tumor, lesions of cerebellar hemisphere or vascular diseases. The effects of gravity and mechanical force exerted on the neck and extremities frequently used to facilitate the neurological procedures when the park-bench position was placed. Several complications related to this position, including decubitus ulcer, air embolism, swelling of facial or neck, or damage to the cervical spinal cord, brachial plexus, and peripheral nerve, have been well-documented [1,2]. Delayed airway obstruction related to park-bench position after posterior fossa surgery has been rarely reported in the literatures. We reported a case of delayed airway obstruction resulting from severe swelling of the neck and face after a posterior fossa surgery in the park bench position
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have