Unilateral Hypoglossal Nerve Palsy after the Use of a Novel Supraglottic Airway Device

• 作者: Bun Hui Ang Kelvin Quek Rachel W. L. Leong Shahridan Fathil
• 来源期刊: 麻醉学期刊(英文)
• 学科: 医学
• 关键词: Airway Complication Nerve Injury LMA
• 年，卷（期）: 2020,（6）
• 页码范围: 225-231
• 页数: 7页
• 分类号: R61

摘要

<strong>Background: </strong> The LMA^® Protector™ Airway is a new supraglottic airway device with Cuff Pilot™ Technology that enables visual monitoring of intra-cuff pressure, to reduce the risk of complications from an overinflated device. <strong>Case: </strong> We present a case of unilateral hypoglossal nerve injury after its use. In our knowledge, this is the first reported case of hypoglossal nerve injury after LMA^® Protector™ use. <strong>Learning Points: </strong> Hypoglossal nerve injury is a rare but distressing complication of LMA use. The greater horn of the hyoid bone is a potential site of injury, as the cuff of the LMA may compress the nerve against bone. In our patient, possible contributing factors included cuff overinflation with/without failure of the Cuff Pilot™ technology, inappropriate sizing and placement of an unfamiliar device. Fortuitously, injury is often neuropraxia with complete recovery in 6 months following conservative management. Consideration should be given to down-sizing the device for Asian patients who tend to have smaller jaws for their weight range. We caution that whilst the green zone of the Cuff Pilot™ corresponds to 40 - 60 cm H₂O cuff pressure, it may be more than the “just-seal” pressure required and the cuff may still be overinflated relative to the size of the patient’s airway.