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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/24890

Title :頚部郭清術術後の神経刺激装置の刺激により横隔神経麻痺をきたした一例
Title alternative :A case of phrenic nerve palsy caused by stimulation of nerve stimulator after radical neck dissection
Authors :加藤, 大貴
又吉, 亮
後藤, 新平
仲宗根, 敏幸
Authors alternative :Kato, Tomoki
Matayoshi, Akira
Goto, Shinpei
Nakasone, Toshiyuki
Authors affiliation :Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of the Ryukyus
Department of Oral and Maxillofacial Surgery, University of the Ryukyus Hospital
Issue Date :2020
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346-888X
Abstract :Phrenic nerve paralysis is a rare complication after radical neck dissection. Here, we describe our experience of a case of transient phrenic paralysis due to invasion by a nerve stimulation device. A 41-year-old woman underwent bilateral radical neck dissection for cervical lymph node metastasis of tongue squamous cell carcinoma. Right radical neck dissection and left supraomohyoid neck dissection were performed under general anesthesia. Postoperative chest X-ray showed prominent elevation of the right diaphragm and positive silhouette sign. Based on these findings, we diagnosed the patient with phrenic nerve paralysis and atelectasis. Because she was hemodynamically stable and phrenic nerve paralysis was unilateral, the decline in respiratory function seemed to be mild. However, the possibility of exacerbation of atelectasis was not excluded because her oxygen saturation decreased frequently even with oxygenation and she was obese (body mass index: 35, height: 154cm, weight: 83kg). Therefore, we decided to implement continuous positive airway pressure in the intensive care unit. On the 8th postoperative day, elevation of the diaphragm was not observed on chest X-ray. The patient was discharged without recurrence of phrenic nerve paralysis after receiving radiation therapy and chemotherapy. Clinicians should carefully consider use of a nerve stimulation device due to the potential risk of paralysis caused by the device, even when used to protect the phrenic nerve during surgery.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/24890
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.39 no.1-4 p.41 -44
Appears in Collections:Ryukyu Medical Journal

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