Case Report
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Omuz Cerrahisi Sırasında Plaj Sandalyesi Pozisyonunda Nadir Görülen Bir Komplikasyon

Year 2022, Volume , Issue 16, 332 - 338, 30.04.2022
https://doi.org/10.38079/igusabder.1072805

Abstract

Amaç: Plaj sandalyesi pozisyonunda omuz patolojilerinin tedavisinde omuz artroskopisi yaygın olarak kullanılan bir işlemdir. Son literatürde genel anestezi altında pozisyon verilmesine bağlı komplikasyonlar bildirilmiştir. Bu çalışmanın amacı, omuz artroskopisi sonrası gelişen büyük auriküler sinir nöropraksisi olgusunu bildirmektir.
Yöntem: 32 yaşında erkek hasta kliniğimize başvurmuş olup semptomlar, fizik muayene ve tarama sonucunda; Bankart lezyonu ön tanısı ile operasyon planlanmıştır. Hastaya genel anestezi altında plaj sandalyesi pozisyonunda endotrakeal entübasyon ile cerrahi uygulanmıştır. Sol kulak, kulak kepçesinin arka yüzünün alt ve orta 1/3'ünde uyuşma ve disestezi şikayeti ile başvurmuştur. EMG çalışmasında büyük auriküler sinirinde (GAN) nöropraksi ortaya çıkmıştır. Semptom ameliyattan iki hafta sonra düzelmeye başlamış ve 6. haftada tamamen düzelmiştir.
Bulgular: Son literatürde GAN nöropraksisi ile ilgili sınırlı sayıda vaka bulunmaktadır. Servikal pleksus ve aurikular bölge üzerindeki baskıyı en aza indirmek için baş ve servikal bölgeye koltuk başlığının ekstra dolgusu ile veya at nalı başlığı kullanılarak özel dikkat gösterilmesini öneriyoruz. Bildiğimiz kadarıyla Türkiye'nin ilk vaka sunumu olarak EMG ile doğrulanan GAN'ın arka dalında nöropraksi gelişmiştir.
Sonuç: Bu olgu, nadir görülen bu komplikasyon hakkında farkındalık yaratmayı amaçlamaktadır. Komplikasyonları önlemek veya azaltmak için plaj sandalyesi konumlandırma için yeni malzemelerin üretilmesi ve kullanılması gerektiğini düşünüyoruz.

References

  • Bek D, Ege T, Erdem Y, Tunay S. Severe cartilage loss caused by metallic anchors in surgical treatment of a Bankart lesion: report of three cases. Joint Diseases and Related Surgery. 2015;26(2):116-119.
  • Gelber PE, Reina F, Caceres E, Monllau JC. A comparison of risk between the lateral decubitus and the beach-chair position when establishing an anteroinferior shoulder portal: a cadaveric study. Arthroscopy. 2007;23(5):522-528.
  • Skyhar MJ, Altchek DW, Warren RF, Wickiewicz TL, O’Brien S.J. Shoulder arthroscopy with the patient in the beach-chair position. Arthroscopy. 1988;4(4):256-259.
  • Peruto CM, Ciccotti MG, Cohen SB. Shoulder arthroscopy positioning: lateral decubitus versus beach chair. Arthroscopy. 2009;25(8):891-896.
  • Hariri A, Nourissat G, Dumontier C, Doursounian L. Pulmonary embolism following thrombosis of the brachial vein after shoulder arthroscopy. A case report. Orthop Traumatol Surg Res. 2009;95(5):377-379.
  • Pohl A, Cullen DJ. Cerebral ischemia during shoulder surgery in the upright position: a case series. J Clin Anesth. 2005;17(6):463-469.
  • Papadonikolakis A, Wiesler ER, Olympio M.A., Poehling G.G. Avoiding catastrophic complications of stroke and death related to shoulder surgery in the sitting position. Arthroscopy. 2008;24(4):481-482.
  • Berry M, Bannister LH, Stranding SM. Nervous system. In: Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al. Gray's Anatomy. 38th ed. New York: Churchill Livingston; 1995:901-1937.
  • Small NC. Complications in arthroscopic surgery of the knee and shoulder. Orthopedics. 1993;16:985–988.
  • Rodeo SA, Forster RA, Weiland AJ. Neurological complications due to arthroscopy. J Bone Joint Surg Am. 1993;75:917–926.
  • Weber SC, Abrams JS, Nottage WM. Complications associated with arthroscopic shoulder surgery. Arthroscopy. 2002;18:88–95.
  • Berjano P, Gonzalez BG, Olmedo JF, Perez-Espana LA, Munilla MG. Complications in arthroscopic shoulder surgery. Arthroscopy. 1998;14:785–788.
  • Holtzman AJ, Glezos CD, Feit EJ, Gruson KI. Arthroscopy. 2017; 33(11):1958-1962.

A Rare Complication with Beach Chair Positioning During Shoulder Surgery

Year 2022, Volume , Issue 16, 332 - 338, 30.04.2022
https://doi.org/10.38079/igusabder.1072805

Abstract

Aim: Shoulder arthroscopy in the beach chair position for treatment of shoulder pathologies is a widely used procedure. In recent literature, complications because of the positioning under general anesthesia have been reported. The objective of this study is to report a case of greater auricular nerve neuropraxia after shoulder arthroscopy.
Method: A 32 old male patient has visited our clinic and based on symptoms, physical examination and screening; an operation has been planned with the diagnosis of Bankart lesion. The surgery was performed under general anesthesia. Endotracheal intubation was performed to the patient in the beach chair position.The patient felt dysesthesia and numbness at the middle and lower third of the posterior facade of his left auricle. EMG study revealed neuropraxia in the greater auricular nerve (GAN). Symptoms have started to recover after two weeks postoperatively and resolved completely by 6 weeks.
Results: In recent literature, there is a restricted amount of cases about GAN neuropraxia. We recommend that special care should be taken to the head and cervical region with extra padding of the headrest or using a horseshoe headrest to minimize the compression over the cervical plexus and auricular region. To our knowledge in the first case report in Turkey, neuropraxia in the posterior branch of GAN developed, which was confirmed with EMG.
Conclusion: The present case aims to raise awareness regarding this rare complication. We think that new materials for beach chair positioning are needed to be produced and used to prevent or diminish complications.

References

  • Bek D, Ege T, Erdem Y, Tunay S. Severe cartilage loss caused by metallic anchors in surgical treatment of a Bankart lesion: report of three cases. Joint Diseases and Related Surgery. 2015;26(2):116-119.
  • Gelber PE, Reina F, Caceres E, Monllau JC. A comparison of risk between the lateral decubitus and the beach-chair position when establishing an anteroinferior shoulder portal: a cadaveric study. Arthroscopy. 2007;23(5):522-528.
  • Skyhar MJ, Altchek DW, Warren RF, Wickiewicz TL, O’Brien S.J. Shoulder arthroscopy with the patient in the beach-chair position. Arthroscopy. 1988;4(4):256-259.
  • Peruto CM, Ciccotti MG, Cohen SB. Shoulder arthroscopy positioning: lateral decubitus versus beach chair. Arthroscopy. 2009;25(8):891-896.
  • Hariri A, Nourissat G, Dumontier C, Doursounian L. Pulmonary embolism following thrombosis of the brachial vein after shoulder arthroscopy. A case report. Orthop Traumatol Surg Res. 2009;95(5):377-379.
  • Pohl A, Cullen DJ. Cerebral ischemia during shoulder surgery in the upright position: a case series. J Clin Anesth. 2005;17(6):463-469.
  • Papadonikolakis A, Wiesler ER, Olympio M.A., Poehling G.G. Avoiding catastrophic complications of stroke and death related to shoulder surgery in the sitting position. Arthroscopy. 2008;24(4):481-482.
  • Berry M, Bannister LH, Stranding SM. Nervous system. In: Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al. Gray's Anatomy. 38th ed. New York: Churchill Livingston; 1995:901-1937.
  • Small NC. Complications in arthroscopic surgery of the knee and shoulder. Orthopedics. 1993;16:985–988.
  • Rodeo SA, Forster RA, Weiland AJ. Neurological complications due to arthroscopy. J Bone Joint Surg Am. 1993;75:917–926.
  • Weber SC, Abrams JS, Nottage WM. Complications associated with arthroscopic shoulder surgery. Arthroscopy. 2002;18:88–95.
  • Berjano P, Gonzalez BG, Olmedo JF, Perez-Espana LA, Munilla MG. Complications in arthroscopic shoulder surgery. Arthroscopy. 1998;14:785–788.
  • Holtzman AJ, Glezos CD, Feit EJ, Gruson KI. Arthroscopy. 2017; 33(11):1958-1962.

Details

Primary Language English
Subjects Medicine
Journal Section Cases
Authors

Nikola AZAR> (Primary Author)
İSTANBUL GELİŞİM ÜNİVERSİTESİ, SAĞLIK HİZMETLERİ MESLEK YÜKSEKOKULU
0000-0003-2911-8961
Türkiye


Serdar YÜKSEL>
UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAĞCILAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF ORTHOPAEDICS AND TRAUMATOLOGY
0000-0001-9796-5033
Türkiye


Hakan ÖZBAY This is me
UNIVERSITY OF HEALTH SCIENCES, İSTANBUL BAĞCILAR HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF ORTHOPAEDICS AND TRAUMATOLOGY
0000-0002-7319-0381
Türkiye

Publication Date April 30, 2022
Published in Issue Year 2022, Volume , Issue 16

Cite

Bibtex @case report { igusabder1072805, journal = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi}, issn = {2536-4499}, eissn = {2602-2605}, address = {İstanbul Gelişim Üniversitesi Sağlık Bilimleri Yüksekokulu - Cihangir Mah. Şehit Jandarma Komando Er Hakan Öner Sk. No: 1 Avcılar / İstanbul / Türkiye}, publisher = {İstanbul Gelisim University}, year = {2022}, number = {16}, pages = {332 - 338}, doi = {10.38079/igusabder.1072805}, title = {A Rare Complication with Beach Chair Positioning During Shoulder Surgery}, key = {cite}, author = {Azar, Nikola and Yüksel, Serdar and Özbay, Hakan} }
APA Azar, N. , Yüksel, S. & Özbay, H. (2022). A Rare Complication with Beach Chair Positioning During Shoulder Surgery . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi , (16) , 332-338 . DOI: 10.38079/igusabder.1072805
MLA Azar, N. , Yüksel, S. , Özbay, H. "A Rare Complication with Beach Chair Positioning During Shoulder Surgery" . İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2022 ): 332-338 <https://dergipark.org.tr/en/pub/igusabder/issue/69769/1072805>
Chicago Azar, N. , Yüksel, S. , Özbay, H. "A Rare Complication with Beach Chair Positioning During Shoulder Surgery". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi (2022 ): 332-338
RIS TY - JOUR T1 - A Rare Complication with Beach Chair Positioning During Shoulder Surgery AU - Nikola Azar , Serdar Yüksel , Hakan Özbay Y1 - 2022 PY - 2022 N1 - doi: 10.38079/igusabder.1072805 DO - 10.38079/igusabder.1072805 T2 - İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 332 EP - 338 VL - IS - 16 SN - 2536-4499-2602-2605 M3 - doi: 10.38079/igusabder.1072805 UR - https://doi.org/10.38079/igusabder.1072805 Y2 - 2022 ER -
EndNote %0 Istanbul Gelisim University Journal of Health Sciences A Rare Complication with Beach Chair Positioning During Shoulder Surgery %A Nikola Azar , Serdar Yüksel , Hakan Özbay %T A Rare Complication with Beach Chair Positioning During Shoulder Surgery %D 2022 %J İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi %P 2536-4499-2602-2605 %V %N 16 %R doi: 10.38079/igusabder.1072805 %U 10.38079/igusabder.1072805
ISNAD Azar, Nikola , Yüksel, Serdar , Özbay, Hakan . "A Rare Complication with Beach Chair Positioning During Shoulder Surgery". İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi / 16 (April 2022): 332-338 . https://doi.org/10.38079/igusabder.1072805
AMA Azar N. , Yüksel S. , Özbay H. A Rare Complication with Beach Chair Positioning During Shoulder Surgery. IGUSABDER. 2022; (16): 332-338.
Vancouver Azar N. , Yüksel S. , Özbay H. A Rare Complication with Beach Chair Positioning During Shoulder Surgery. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2022; (16): 332-338.
IEEE N. Azar , S. Yüksel and H. Özbay , "A Rare Complication with Beach Chair Positioning During Shoulder Surgery", İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi, no. 16, pp. 332-338, Apr. 2022, doi:10.38079/igusabder.1072805

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