Idiopathic Facial Nerve Paralysis after Hysteroscopy under General Anesthesia
Abstract
More than 50% of peripheral facial paralysis are idiopathic (Bell’s palsy). Second frequent reason thought to be trauma (aproximately 20%) and the infection as the third. Postoperative facial paralysis is a rare condition that can appear probably due to compression to nerve upon mechanical stress or distention of nerve during mask ventilation via mask or due to patient positioning. Intraoperative hypotension, hypovolemia, hypoxia, electrolyte imbalance are other risk factors. A 38-year-old American Society of Anesthesiology Classification. (ASA I) woman was scheduled for hysteroscopy due to endometrial polyp. Patient was operated with general anesthesia via larengeal mask. After recovery patient complained about facial paresthaesia. It was defined that patient could not lift the right eyebrow and right nasolabial fold was erased and rest of the branches of facial nerve and other cranial nerves were normal. Distal facial nerve paralysis was diagnosed after neurological consultation. Patient fully recovered in three weeks after medical treatment. In this case there was no difficult mask ventilation and patient was in supine position. Also there was no any other reason give rise to facial paralysis during surgery. When patient questioned in detailed she complained prodromal earache one day before the operation. We believe that facial paralysis coincided with the operation, factors of general anesthesia and surgical stress increased the severity of this pathology that had already been in development process.
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References
- 1. Bayındır T, Tan M, Selimoğlu E. Bell Paralizisinde Tanı ve Tedavi Yöntemleri. Kuak Burun Boğaz ve Baş Boyun Cerrahisi Dergisi 2011; 10: 18-30
- 2. Cansız H, Pamukçu M, Edizer T. Fasiyal Paraliziler. Klinik gelişim 2005; 18:96-104
- 3. Gagyor I, Madhok VB, Daly F et al. Antiviral treatment for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2015; 9:11
- 4. Burges LP, Yim DV, Lepore ML. Bell’s palsy: the steroid controversy revisited. Laryngoscope.2009; 94: 1472-1476
- 5. Prescott CA. İdiopathic facial nerve palsy (the effect of treatment with steroids). Journal of Laryngology and Otology 1988; 102: 403-407
- 6. Ananthanarayan C, Rolbin SH, Hew E. Facial nerve paralysis following mask anaesthesia.Canadian Journal of Anaesthesia 1988; 35: 102-103
- 7. Baidya DK, Bhoi D, Sinha R et al. Partial facial nerve paralysis after laparoscopic surgery under general anaesthesia.Indian Journal of Anaesthesia. 2011; 55: 416-418
- 8. Lonjaret L, Vuillaume C, Fourcade O et al. Idiopathic facial paralysis following general anesthesia.Journal of Anaesthesiology Clinical Pharmacology. 2012; 28: 536-537
- 9. Glabaur DT. Facial nerve paralysis after general anaesthesia. Anesthesiology. 1986; 65: 516–517
- 10. Lakraj AA, Moqhimi N, Jabbari B. Sialorrhea: anatomy, pathophysiology and treatmentwith emphasis on the role of botilinum toxins. Toxins(Basel) 2013; 21: 1010-1031