Afectación del nervio hipogloso (XII), nervio maxilar (V2) y nervio lingual (V3) tras cirugía laríngea. A propósito de un caso.

Abstract

Introduction/ Laryngeal surgery requires an orotracheal intubation and sometimes a Kleinsasser suspensor which allows access to the surgical material and manipulation of the area to be operated. These devices can compress different cranial nerves, causing sensory alterations, dysphonia, dysphagia, and dysglosia.Description / A 34-year-old female, required laryngeal microsurgery to resect vocal cord polyps using a Kleinsasser suspensor. Two weeks after, the patient reported pain in the right temporomandibular joint, choking with fluids and had vocal fatigue. After 4 weeks previous symptoms subsided, but in the physical examination a right deviation of the tongue was observed with an atrophy of the right half tongue and hypoesthesia of its anterior two thirds and of the nasal wing, superior lip and right inferior orbital rim. She still presents vocal fatigue. The fibrolaryngoscopy was normal. Diagnosis: functional dysphonia and a hypoglossal nerve and trigeminal nerve palsy: the maxillary branch and the the lingual nerve of the mandibular branch. Treatment: Vocal training and exercises to improve lingual dexterity. After 3 months she recovered normal phonation and sensibility. A slight lingual deviation persists, but with no interference in functionality.Discussion / Neuroapraxias lasts days or 3-6 months. The diagnosis is clinical. Fibrolaryngoscopy can help detect severe functional cases. In those cases, it is advisable to request a neurophysiology study to help establish a prognosis. Rehabilitation intervention participates in the management of symptoms or possible sequelae.Conclusions/These complications influence in the duration and severity of postsurgery symptoms, so they must be ruled out.