Abstract
A 67-year-old woman underwent right radical neck dissection for cervical lymph node metastasis from maxillary gingival carcinoma. Two months later, metastasis in the left superior internal jugular lymph nodes were discovered, and left radical neck dissection was performed. Postoperatively, airway obstruction occurred despite performing extubation after confirming that the patient had fully recovered from anesthesia. Bilateral hypoglossal nerve palsy was diagnosed and the patient was reintubated. After extubation on the following day, airway obstruction was relieved, but slurred speech and impaired swallowing were persistent. In view of this, hypoglossal nerve function should be examined before the second radical neck dissection on the contralateral side.
Highlights
Hypoglossal nerve palsy can occur with tumors, trauma, stroke, multiple sclerosis, Guillan Barre neuropathy infection [1] and head and neck injury [2]
We present a case of airway obstruction caused by bilateral hypoglossal nerve palsy following second radical neck dissection and subsequent reintubation
We experienced a case of airway obstruction after second radical neck dissection
Summary
Hypoglossal nerve palsy can occur with tumors, trauma, stroke, multiple sclerosis, Guillan Barre neuropathy infection [1] and head and neck injury [2]. Presence of a tumor or a cyst is the most leading cause. There are reports of hypoglossal nerve palsy after surgery; carotid endarterectomy [3,4] or atlanto-axial fixation [5]. Unilateral hypoglossal palsy often goes unnoticed due to unremarkable symptoms. When bilateral hypoglossal nerve palsy occurs, serious clinical symptoms including airway obstruction due to tongue root depression, stuttering and deglutition disorder can develop [3]. We present a case of airway obstruction caused by bilateral hypoglossal nerve palsy following second radical neck dissection and subsequent reintubation
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