Abstract
BackgroundAssociated laryngeal paralysis is a clinical condition merged with other cranial nerve disorders associated with vocal cord paralysis. It is a rare complication in patients after general anesthesia. Here, we report our experience with a patient who developed associated laryngeal paralysis after oral surgery.Case presentationA healthy 31-year-old man underwent extraction of horizontally impacted wisdom teeth in the bilateral mandible under general anesthesia. During the surgery, no significant changes in respiratory and cardiovascular parameters or neurosurgical abnormalities occurred. After the surgery, the patient was diagnosed with aspiration pneumonia. Furthermore, the results of otorhinolaryngological and neurological examinations led to a diagnosis of a combination of bilateral glossopharyngeal and vagus nerve paralysis, right recurrent nerve paralysis, and right hypoglossal nerve paralysis. In this case, seriously associated peripheral laryngeal paralysis with repeated episodes of aspiration pneumonia improved in approximately 6 months with rehabilitation and vitamin B12 administration, and no complications remained.ConclusionsWe suggest that the anesthesiologist should take care of each procedure minutely. It is important to diagnose cases of nerve palsy as soon as possible to reduce the damage. Having had experience with this case, we believe sharing our experience with anesthesiologists is important.
Highlights
Associated laryngeal paralysis is a clinical condition merged with other cranial nerve disorders associated with vocal cord paralysis [1] and is a rare complication in patients after general anesthesia [2]
We report our experience with a patient who developed postoperative associated laryngeal paralysis as well as a literature review
There are reports regarding the onset of associated laryngeal paralysis after oral surgery [2, 3], there are no reports on a combination of bilateral glossopharyngeal and vagus nerve paralysis, right recurrent nerve paralysis, and right hypoglossal nerve paralysis after tooth extraction under general anesthesia so far
Summary
It is not so rare that each of the nerves including the glossopharyngeal nerve, vagus nerve, and hypoglossal nerve are paralyzed after surgery. There is no report on the occurrence of these three nerves being paralyzed simultaneously. We suggest that the anesthesiologist should take care of each procedure minutely, including mask ventilation, tracheal intubation, and close monitoring of cuff pressure. It is important to diagnose cases of nerve palsy as soon as possible to reduce the damage. Having had experience with this case, we believe that sharing our experience with anesthesiologists is important
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