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Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations

Patient: Female, 52-year-old Final Diagnosis: Bilateral lingual nerve palsy • cranial nerve injury Symptoms: Loss of taste • loss of tongue sensation • voice hoarseness Medication: — Clinical Procedure: Endotracheal Intubation Specialty: Anesthesiology • Neurology OBJECTIVE: Rare disease BACKGROUND:...

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Autores principales: Khashan, Abdallah, Carson, Michael, Pandya, Vanil, Wahba, Abram R., Khashan, Doha Mohamed Ahmed, Noor, Emad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552861/
https://www.ncbi.nlm.nih.gov/pubmed/36197841
http://dx.doi.org/10.12659/AJCR.937192
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author Khashan, Abdallah
Carson, Michael
Pandya, Vanil
Wahba, Abram R.
Khashan, Doha Mohamed Ahmed
Noor, Emad
author_facet Khashan, Abdallah
Carson, Michael
Pandya, Vanil
Wahba, Abram R.
Khashan, Doha Mohamed Ahmed
Noor, Emad
author_sort Khashan, Abdallah
collection PubMed
description Patient: Female, 52-year-old Final Diagnosis: Bilateral lingual nerve palsy • cranial nerve injury Symptoms: Loss of taste • loss of tongue sensation • voice hoarseness Medication: — Clinical Procedure: Endotracheal Intubation Specialty: Anesthesiology • Neurology OBJECTIVE: Rare disease BACKGROUND: Endotracheal intubation is an essential procedure to protect the airway. However, immediate complications like voice hoarseness, cervical spine injury, and tooth trauma are common. One of the rarest complications is lingual nerve palsy. Risk factors include small airway instruments, non-supine position, nitrous oxide use, and difficult intubation. Only 15 cases of lingual nerve injury were identified worldwide, and only 2 of them were bilateral. This case report describes the third case of bilateral lingual nerve palsy after intubation. CASE REPORT: We present a 52-year-old woman admitted for a total abdominal hysterectomy. Postoperatively, the patient noted voice hoarseness, left tongue numbness, and loss of taste on both sides of the tongue. MRI brain revealed no new masses or lesions, and a diagnosis of bilateral lingual nerve palsy was made. She was treated conservatively with symptom observation for 14 weeks. On follow-up, she remained with only a patch of numbness and dryness, and loss of taste on the top middle area of the tongue. CONCLUSIONS: Lingual nerve palsy is a very rare but devastating adverse effect of airway manipulation. Symptoms can include dryness, loss of sensation, and loss of taste of the anterior two-thirds of the tongue on the ipsilateral side. Salivary function assessment is important to determine the location of peripheral nerve injury. All possible causes like stroke, hemorrhage, and nerve impingement should be evaluated. MRI is advised to exclude central etiologies. Steroids may be used to decrease tissue edema and inflammation.
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spelling pubmed-95528612022-10-25 Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations Khashan, Abdallah Carson, Michael Pandya, Vanil Wahba, Abram R. Khashan, Doha Mohamed Ahmed Noor, Emad Am J Case Rep Articles Patient: Female, 52-year-old Final Diagnosis: Bilateral lingual nerve palsy • cranial nerve injury Symptoms: Loss of taste • loss of tongue sensation • voice hoarseness Medication: — Clinical Procedure: Endotracheal Intubation Specialty: Anesthesiology • Neurology OBJECTIVE: Rare disease BACKGROUND: Endotracheal intubation is an essential procedure to protect the airway. However, immediate complications like voice hoarseness, cervical spine injury, and tooth trauma are common. One of the rarest complications is lingual nerve palsy. Risk factors include small airway instruments, non-supine position, nitrous oxide use, and difficult intubation. Only 15 cases of lingual nerve injury were identified worldwide, and only 2 of them were bilateral. This case report describes the third case of bilateral lingual nerve palsy after intubation. CASE REPORT: We present a 52-year-old woman admitted for a total abdominal hysterectomy. Postoperatively, the patient noted voice hoarseness, left tongue numbness, and loss of taste on both sides of the tongue. MRI brain revealed no new masses or lesions, and a diagnosis of bilateral lingual nerve palsy was made. She was treated conservatively with symptom observation for 14 weeks. On follow-up, she remained with only a patch of numbness and dryness, and loss of taste on the top middle area of the tongue. CONCLUSIONS: Lingual nerve palsy is a very rare but devastating adverse effect of airway manipulation. Symptoms can include dryness, loss of sensation, and loss of taste of the anterior two-thirds of the tongue on the ipsilateral side. Salivary function assessment is important to determine the location of peripheral nerve injury. All possible causes like stroke, hemorrhage, and nerve impingement should be evaluated. MRI is advised to exclude central etiologies. Steroids may be used to decrease tissue edema and inflammation. International Scientific Literature, Inc. 2022-10-05 /pmc/articles/PMC9552861/ /pubmed/36197841 http://dx.doi.org/10.12659/AJCR.937192 Text en © Am J Case Rep, 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Khashan, Abdallah
Carson, Michael
Pandya, Vanil
Wahba, Abram R.
Khashan, Doha Mohamed Ahmed
Noor, Emad
Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations
title Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations
title_full Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations
title_fullStr Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations
title_full_unstemmed Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations
title_short Bilateral Lingual Nerve Injury Following Endotracheal Intubation: Risk Factors and Diagnostic Considerations
title_sort bilateral lingual nerve injury following endotracheal intubation: risk factors and diagnostic considerations
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552861/
https://www.ncbi.nlm.nih.gov/pubmed/36197841
http://dx.doi.org/10.12659/AJCR.937192
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