title: [Hypoglossal nerve neuropraxia after shoulder hemiarthroplasty].
abstract: We report a case of hypoglossal nerve damage after shoulder hemiarthroplasty with the patient in "beach chair" position, performed with general anesthesia with orotracheal intubation, and without complications. An ultrasound-guided interscalene block was previously performed in an alert patient. After the intervention, the patient showed clinical symptomatology compatible with paralysis of the right hypoglossal nerve that completely disappeared after 4 weeks. Mechanisms such as hyperextension of the neck during intubation, endotracheal tube cuff pressure, excessive hyperextension, or head lateralization during surgery have been described as causes of this neurological damage. We discuss the causes, the associated factors and suggest preventive measures.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España. Electronic address: laurapariente.lpj@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Pariente
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: P
authors.initials: P
authors.lastname: Camarena
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Koo
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Sabaté
authors.affiliation: Servicio de Traumatología y Ortopedia, Hospital Universitario de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Armengol
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects; D001178:Arthroplasty; D015897:Comorbidity; D019416:Head Movements; D006801:Humans; D061228:Hypoglossal Nerve Injuries / Q000209:etiology* / Q000517:prevention & control; D007431:Intraoperative Complications / Q000209:etiology; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000517:prevention & control; D056888:Patient Positioning / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012075:Remission, Spontaneous; D012785:Shoulder Joint / Q000601:surgery*; D018084:Ultrasonography, Interventional
keywords: Bloqueo interescalénico; Cirugía de hombro; Ecografía; Hipogloso; Hypoglossal; Interscalene block; Neuroapraxia; Neuropraxia; Posición quirúrgica; Shoulder surgery; Surgical positioning; Ultrasound