BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their qua...BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their quality of life.We present an unusual case of LNI caused by the use of an LMA in percutaneous nephrolithotomy(PCNL).CASE SUMMARY A 49-year-old man presented to our hospital with a 3-year history of intermittent left lower back pain.Abdominal computed tomography showed a 25 mm×20 mm stone in the left renal pelvis.PCNL surgery using LMA was performed to remove the renal stone.The patient reported numbness on the tip of his tongue after the operation,but there were no signs of swelling or trauma.The patient was diagnosed with LNI after other possible causes were ruled out.The symptom of numbness eventually improved after conservative medical therapy for 1 wk.The patient completely recovered 3 wk after surgery.CONCLUSION This is the first case report describing LNI with the use of LMA in PCNL.In our case,an inappropriate LMA size,intraoperative movement,and a specific surgical position might be potential causes of this rare complication.展开更多
Running through the infratemporal fossa is the lingual nerve （i.e. the third branch of the posterior trunk of the mandibular nerve）. Due to its location, there are various anatomic structures that might entrap and p...Running through the infratemporal fossa is the lingual nerve （i.e. the third branch of the posterior trunk of the mandibular nerve）. Due to its location, there are various anatomic structures that might entrap and potentially compress the lingual nerve. These anatomical sites of entrapment are： （a） the partially or completely ossified pterygospinous or pterygoalar ligaments; （b） the large lamina of the lateral plate of the pterygoid process; and （c） the medial fibers of the anterior region of the lateral pterygoid muscle. Due to the connection between these nerve and anatomic structures, a contraction of the lateral pterygoid muscle, for example, might cause a compression of the lingual nerve. Any variations in the course of the lingual nerve can be of clinical significance to surgeons and neurologists because of the significant complications that might occur. To name a few of such complications, lingual nerve entrapment can lead to： （a） numbness, hypoesthesia or even anesthesia of the tongue’s mucous glands; （b） anesthesia and loss of taste in the anterior two-thirds of the tongue; （c） anesthesia of the lingual gums; and （d） pain related to speech articulation disorder. Dentists should, therefore, be alert to possible signs of neurovascular compression in regions where the lingual nerve is distributed.展开更多
A 34-year-old woman visited our clinic with complaints of trismus, numbness in the left half of the tongue, and pain in tooth 34. At the patient’s initial visit to our clinic, the maximum assisted jaw opening movemen...A 34-year-old woman visited our clinic with complaints of trismus, numbness in the left half of the tongue, and pain in tooth 34. At the patient’s initial visit to our clinic, the maximum assisted jaw opening movement was 20 mm, pointing to severe trismus. The patient complained of spontaneous pain in tooth 34 but did not evince percussion pain. Her pain remained unchanged even under local anesthesia. Radiography showed no pathological findings. A tenderness test of masticatory muscles failed to induce pain. The presence of severe trismus argued against temporomandibular disorders, resulting in suspicion of other inflammatory disease. In view of numbness of the tongue, other diseases such as inflammation or neoplastic disease in the head and neck region were considered. The patient was referred to the departments of neurosurgery and otolaryngology for examination. The results of MRI and CT diagnosis led to the identification of acute myositis of the left medial pterygoid muscle requiring the prescription of nonsteroidal anti-inflammatory drugs, and relaxation of mandibular muscles. With time, maximum unassisted jaw opening improved and pain in tooth 34 ceased, but tongue numbness persisted. The condition was attributed to compression of lingual nerve (LN) and mandibular nerve (MN) resulting from medial pterygoid muscle inflammation.展开更多
文摘BACKGROUND Lingual nerve injury(LNI)is a rare complication following the use of laryngeal mask airway(LMA).The occurrence of this unexpected complication causes uncomfortable symptoms in patients and worsens their quality of life.We present an unusual case of LNI caused by the use of an LMA in percutaneous nephrolithotomy(PCNL).CASE SUMMARY A 49-year-old man presented to our hospital with a 3-year history of intermittent left lower back pain.Abdominal computed tomography showed a 25 mm×20 mm stone in the left renal pelvis.PCNL surgery using LMA was performed to remove the renal stone.The patient reported numbness on the tip of his tongue after the operation,but there were no signs of swelling or trauma.The patient was diagnosed with LNI after other possible causes were ruled out.The symptom of numbness eventually improved after conservative medical therapy for 1 wk.The patient completely recovered 3 wk after surgery.CONCLUSION This is the first case report describing LNI with the use of LMA in PCNL.In our case,an inappropriate LMA size,intraoperative movement,and a specific surgical position might be potential causes of this rare complication.
文摘Running through the infratemporal fossa is the lingual nerve （i.e. the third branch of the posterior trunk of the mandibular nerve）. Due to its location, there are various anatomic structures that might entrap and potentially compress the lingual nerve. These anatomical sites of entrapment are： （a） the partially or completely ossified pterygospinous or pterygoalar ligaments; （b） the large lamina of the lateral plate of the pterygoid process; and （c） the medial fibers of the anterior region of the lateral pterygoid muscle. Due to the connection between these nerve and anatomic structures, a contraction of the lateral pterygoid muscle, for example, might cause a compression of the lingual nerve. Any variations in the course of the lingual nerve can be of clinical significance to surgeons and neurologists because of the significant complications that might occur. To name a few of such complications, lingual nerve entrapment can lead to： （a） numbness, hypoesthesia or even anesthesia of the tongue’s mucous glands; （b） anesthesia and loss of taste in the anterior two-thirds of the tongue; （c） anesthesia of the lingual gums; and （d） pain related to speech articulation disorder. Dentists should, therefore, be alert to possible signs of neurovascular compression in regions where the lingual nerve is distributed.
文摘A 34-year-old woman visited our clinic with complaints of trismus, numbness in the left half of the tongue, and pain in tooth 34. At the patient’s initial visit to our clinic, the maximum assisted jaw opening movement was 20 mm, pointing to severe trismus. The patient complained of spontaneous pain in tooth 34 but did not evince percussion pain. Her pain remained unchanged even under local anesthesia. Radiography showed no pathological findings. A tenderness test of masticatory muscles failed to induce pain. The presence of severe trismus argued against temporomandibular disorders, resulting in suspicion of other inflammatory disease. In view of numbness of the tongue, other diseases such as inflammation or neoplastic disease in the head and neck region were considered. The patient was referred to the departments of neurosurgery and otolaryngology for examination. The results of MRI and CT diagnosis led to the identification of acute myositis of the left medial pterygoid muscle requiring the prescription of nonsteroidal anti-inflammatory drugs, and relaxation of mandibular muscles. With time, maximum unassisted jaw opening improved and pain in tooth 34 ceased, but tongue numbness persisted. The condition was attributed to compression of lingual nerve (LN) and mandibular nerve (MN) resulting from medial pterygoid muscle inflammation.
