관골복합골절 수술 후 발생한 일시적 설하신경 마비의 증례보고

Transient Hypoglossal Nerve Palsy after Open Reduction of Zygomatic Complex Fracture

  • 김지욱 (비즈 성형외과) ;
  • 김우섭 (중앙대학교 의과대학 성형외과학교실) ;
  • 권남호 (중앙대학교 의과대학 성형외과학교실) ;
  • 김한구 (중앙대학교 의과대학 성형외과학교실) ;
  • 배태희 (중앙대학교 의과대학 성형외과학교실)
  • Kim, Jee Wook (VIZ Plastic Surgery Center) ;
  • Kim, Woo Seob (Department of Plastic and Reconstructive Surgery, College of Medicine, Chung-Ang University) ;
  • Kwon, Nam Ho (Department of Plastic and Reconstructive Surgery, College of Medicine, Chung-Ang University) ;
  • Kim, Han Koo (Department of Plastic and Reconstructive Surgery, College of Medicine, Chung-Ang University) ;
  • Bae, Tae Hui (Department of Plastic and Reconstructive Surgery, College of Medicine, Chung-Ang University)
  • 투고 : 2008.09.22
  • 심사 : 2008.12.02
  • 발행 : 2009.01.15

초록

Purpose: Isolated hypoglossal nerve palsy is a rare manifestation of various underlying disease. This article presents a rare complication of general anesthesia associated with an surgical procedure on a case of zygomatic fracture. Methods: An 18-year-old female patient was referred to our department by painful swelling on her left zygomatic area after the traffic accident. Left zygomatic complex fracture was identified on the simple x-ray and facial bone CT scan, and the fracture was treated with open reduction and internal fixation under general anesthesia. On the first postoperative day, she complained of difficulty in swallowing solid food, dysarthria and deviated tongue to her right side. There was no abnormal findings on the neurological examination, brain MRI and routine chemistry. She was diagnosed with transient hypoglossal nerve palsy and dexamethasone with multi-vitamins was administrated intravenously for 5 days. Results: The symptoms were completely resolved by the ninth postoperative day and the patient was discharged without any other complications. Conclusion: The hypoglossal(cranial nerve XII)nerve supplies motor innervation to all of the ipsilateral extrinsic and intrinsic tongue muscles. The hypoglossal nerve damage may caused by the compression between the airway and the hyoid bone during the endotracheal intubation, and direct trauma due to excessive pressure or neck extension. We described a rare case of unintended injury to hypoglossal nerve and care must be taken not to cause the hypoglossal nerve damage especially in facial plastic surgery with excessive neck extension under general anesthesia.

키워드

참고문헌

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