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A RARE COMPLICATION OF DIRECT LARYNGOSCOPY: UNILATERAL HYPOGLOSSAL NERVE PALSY

   Yücel, Levent; Büyükatalay, Zahide Çiler; Yorulmaz, İrfan

The most common complications of direct laryngoscopy, which is an indispensable part of otolaryngology practice, are minor mucosal lesions. Rarely, hypoglossal nerve, vocal fold, and lingual nerve palsies may occur. This case presentation is about unilateral hypoglossal nerve palsy following direct laryngoscopy. A 60-year-old-man was admitted with a complaint of hoarseness for 3 months. Direct laryngoscopy and biopsy of the right vocal fold were performed with the preliminary diagnosis of glottic cancer. The day after surgery, he complained of dysphagia. The tongue deviated to the left side of the tongue while protrusion with hypotonia of the left anterior two-thirds. Computerized tomography was performed to exclude hematoma, regarding anticoagulant use before surgery. The palsy completely recovered after 2 months of surgery without any treatment. Shifting of laryngoscope from the midline to the left side for better visualization of the right vocal cord may be the reason for this palsy. Care should be taken to keep the laryngoscope in the midline as much as possible during surgery.

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