| Japanese |
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| Title | 僧帽弁形成術のために使用したTEEプローブが原因と思われる術後反回および舌下神経麻痺をきたした一症例 |
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| Subtitle | 症例 |
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| Authors | 橘かおり, 久野健二郎, 小林繁明, 森本裕二, 劔物修 |
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| Organization | 北海道大学大学院医学研究科高次診断治療学専攻侵襲制御医学講座 |
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| Journal | 循環制御 |
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| Volume | 23 |
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| Number | 4 |
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| Page | 449-451 |
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| Year/Month | 2002/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 経食道心エコー法（trans-esophageal echocardiography；TEE）プローブ挿入後に著明な甲状軟骨の突出を認め, 術後に反回神経および舌下神経麻痺をきたした症例を経験したので報告する. 症例 51歳男性, 身長172cm, 体重59kg, 僧帽弁逆流症に対し僧帽弁形成術が予定された. 僧帽弁逆流の程度は3-4度で弁の逸脱および左房と左室の拡大を伴い, NYHAの2度であった. 両側肺に巨大ブラが認められたが, 一秒率81.6％と呼吸機能は良好であった. 手術経過 麻酔前投薬は施行していなかった. ミダゾラムとフェンタニルで麻酔を導入後, ベクロニウムで筋弛緩を得て気管挿管を行い, セボフルランおよびフェンタニルで麻酔を維持した. 麻酔導入後に右内頸静脈より中心静脈カテーテルおよび肺動脈カテーテルを留置し, 手術のため頸部伸展位をとり, TEEプローブ（HEWLETT PACKARD, 径10mm）を挿入した. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Trans-esophageal echocardiography, Hypoglossal nerve, Recurrent nerve, Paralysis, Complication, Thyroid cartilage |
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| English |
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| Title | The Hypoglossal Nerve and Recurrent Nerve Palsy After Mitral Valve Plasty； Is insertion of a Transesophageal Echocardiography Probe Insertion a Cause？ |
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| Subtitle | |
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| Authors | Kaori Tachibana, Kenjiro Hisano, Shigeaki Kobayashi, Yuji Morimoto, Osamu Kemmotsu |
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| Organization | Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine |
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| Journal | Circulation Control |
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| Volume | 23 |
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| Number | 4 |
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| Page | 449-451 |
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| Year/Month | 2002/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 51-yr-old man was performed mitral valve plasty for mitral valve regurgitation and prolapse, General anesthesia and tracheal intubation proceeded without any difficulty and the head was a little dorsiflexed for surgery. Resistance and considerable extrusion of thyroid cartilage was observed on insertion of transesopharyngeal echocardiography （TEE） probe. Although X-ray and computed tommography showed no traumatic injury, surgery was once postponed. Neither respiratery obstruction nor dysphagia was found after extubation. Proposed surgery was done without any complication one week after. The patient complained dysphagia, discomfort of the tongue and a some hoarsness 24 hours after extubation. Neurologic examination and magnetic resonance imaging of the head revealed no abnormal findings and clinical examination revealed peripheral palsy of the hypoglossal nerve and reccurent nerve on the right side. Thirty days later, the mobility of the tongue and vocal code was back to almost normal without any specific treatments. Compression of the tongue by the TEE plobe might have a major role for this complication together with 6 hours' extension of the neck during surgery. |
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| Practice | Basic medicine |
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| Keywords | Trans-esophageal echocardiography, Hypoglossal nerve, Recurrent nerve, Paralysis, Complication, Thyroid cartilage |
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