| Description |
When providing anesthesia for patients in the sitting position, important considerations must be made regarding patient positioning in order to avoid nerve injuries. Damage to both the lingual and hypoglossal nerves can occur from an overinflated endotracheal tube cuff, hyperextension of the head and neck, or from direct laryngoscopy alone. 1,2 A thorough understanding of the anatomy of both these nerves is crucial to identifying potential causes of nerve damage. The following case report involves a patient who underwent a rotator cuff repair in the sitting position and developed numbness and deviation of the tongue on postoperative day one. This case report highlights the importance of understanding all factors that can contribute to compression of the hypoglossal and lingual nerve and what steps can be taken to best prevent nerve injuries from occurring. Careful and atraumatic laryngoscopy, monitoring of endotracheal cuff pressure, and proper patient positioning are all important steps to take to prevent lingual and hypoglossal nerve damage. |
