Case Report
Tongue paralysis after orotracheal intubation in a patient with primary mediastinal tumor: a case report
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* Corresponding author: Esther Uña aunacid@hotmail.com
1 Medical Oncology Service, Clinical University Hospital, Valladolid, Spain
2 Intensive Care Unit, Clinical University Hospital, Valladolid, Spain
3 Thoracic Surgery Service, Clinical University Hospital, Valladolid, Spain
Cases Journal 2009, 2:9301 doi:10.1186/1757-1626-2-9301
Published: 10 December 2009Abstract
Introduction
Several lesions have been described as post-intubation complications. Most frequent are injuries of the pharynx/larynx or trachea. Cranial nerve injury following routine endo-tracheal intubation appears to be rare, and most reports describe Tapia's syndrome with hypoglossus/recurrent laryngeal nerve paralysis; cases that describe only bilateral hypoglossus palsy are infrequent. The cause is attributed to neuropathy of the nerve, provoked by compression following inflation of the cuff within the larynx or damage after neck hyperextension during a difficult intubation. However, similar cases after non-traumatic intubation have not been reported.
Case presentation
We report here a case of bilateral hypoglossus palsy in a young man undergoing a diagnostic anterior mediastinotomy that was attributed to prolonged non-complicated oro-tracheal intubation. Progressive recovery of function by the patient supports neuropraxic damage as the cause.
Conclusion
To avoid such problems, special attention should be paid to the correct positioning of the head during surgery or during rapidly performed tracheostomy if prolonged intubation is anticipated.