title: [A case of postoperative palsy of the brachial plexus and facial nerve caused by use of cervical collar during lung surgery].
abstract: We report a case of palsy of the brachial plexus and facial nerve manifested after surgery for lung cancer in a 77-year-old female who also had a retroodontoid pseudotumor. Lobectomy was conducted with the patient in a left lateral position. For the purpose of cervical stabilization, the orthopedic surgeon recommended the use of a cervical collar. During the operation, both of her arms were abducted at nearly 80 degrees. On the second postoperative day, the patient complained of sensory disturbances in the lateral area of her left brachium and forearm, which are innervated by the 5th and 6th cervical spinal nerves from the brachial plexus. She also complained that she could not abduct and flex her left shoulder, and could not flex her left elbow at all. Simultaneously, facial nerve palsy was observed in her left lower lip. During the operation, her shoulders were forcibly rotated internally and were extremely abducted, resulting in a narrowed distance between the lower jaw and the shoulder and stretching of the brachial plexus. Under this situation, the cervical collar was pressing strongly upon her neck and lower jaw, which might have produced the brachial plexus complication and facial nerve palsy.
authors.affiliation: Department of Anesthesia and Resuscitation, Yamagata University School of Medicine, Yamagata 990-9585.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Abe
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Miura
authors.forename: Sumio
authors.initials: S
authors.lastname: Amagasa
authors.forename: Akira
authors.initials: A
authors.lastname: Kato
authors.forename: Hideo
authors.initials: H
authors.lastname: Horikawa
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D020516:Brachial Plexus Neuropathies / Q000209:etiology*; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D009333:Neck; D009989:Orthotic Devices / Q000009:adverse effects*; D010243:Paralysis / Q000209:etiology*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000209:etiology*