Anesth Pain Med.  2017 Oct;12(4):398-401. 10.17085/apm.2017.12.4.398.

Quadriplegia as a position-related complication after parotidectomy: the need for cooperation between anesthesiologists and surgeons when positioning patients: A case report

• Shim SM
• Park JH
• Hyun DM
• Cho SH
• Lee HM

• KMID: 2405862
• DOI: http://doi.org/10.17085/apm.2017.12.4.398

Abstract

During surgery, the patient is positioned optimally according to the type of operation. Careful attention is required because damage associated with patient positioning may occur during the course of the surgery. Here, we present a case of hyperextension neck injury observed following parotidectomy. A 68-year-old man who was diagnosed with a parotid tumor underwent an elective right partial superficial parotidectomy. After surgery, the patient was not able to move his upper and lower extremities and experienced voiding difficulty. Cervical magnetic resonance imaging showed spinal cord injury at the C3-4 and C5-6 levels. High-dose steroid treatment was started, and emergency laminoplasty C4-5 to C5-6 was performed. Following laminoplasty, motor function was almost fully recovered, but proprioception was weak, and voiding difficulty remained a problem. The patient received rehabilitation treatment in the hospital for about 3 months, demonstrating improvement. He was discharged and continued treatment in the outpatient department.

Keyword

Cervical spondylolsis; Parotidectomy; Positioning; Spinal cord injury

MeSH Terms

Aged
Emergencies
Humans
Laminoplasty
Lower Extremity
Magnetic Resonance Imaging
Neck Injuries
Outpatients
Patient Positioning
Proprioception
Quadriplegia*
Rehabilitation
Spinal Cord Injuries
Surgeons*

Figure

• 

  Fig. 1 Sagittal T2-weighted magnetic resonance imaging (MRI) before laminoplasty. Cervical MRI shows broad-based disc extrusion and adjacent ossification of posterior longitudinal ligament at C4-5 and C5-6, and T2 high signal intensity in spinal cord from C3-4 to C5-6.

• 

  Fig. 2 Neck computed tomography obtained before parotidectomy. Image shows cervical spondylosis and ossification of posterior longitudinal ligament.

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