Lingual nerve injury following the use of an i-gel™ laryngeal mask
Authors
Renes S.H. et al.
Publication
Anaesthesia 2011; 66 (3): 226-227.
Summary
- A case of bilateral lingual nerve damage following the use of the i-gel™ supraglottic airway device was reported in a 69-year-old male who had undergone open inguinal herniorrhaphy under general anaesthesia
- Use of the i-gel™ supraglottic airway device may result in damage to the lingual nerve
Case report:
- A case of bilateral lingual nerve damage following the use of the i-gel™ supraglottic airway device was reported in a 69-year-old male who had undergone open inguinal herniorrhaphy under general anaesthesia
- The patient was American Society of Anesthesiologists physical status 1 and had a body weight of 78 kg
- The nerve damage manifested as loss of taste and bilateral numbness in the anterior part of the tongue in the postoperative period
- A clinical examination revealed no abnormalities in the appearance and movement of the tongue
- A diagnosis of isolated bilateral lingual nerve injury was made following consultation with a neurologist and an ear, nose and throat surgeon
- Conservative treatment was recommended and symptoms had resolved after 8 weeks post-surgery
- Insertion of the size 4 i-gel™ device (as per the manufacturer’s instructions) was successful and no adverse events occurred during the maintenance of and emergence from anaesthesia
- During volume-controlled ventilation with an airway pressure that was less than 20 cm H2O there was no apparent air leak
Findings:
- The nerve damage reported in this patient was likely the result of certain design features of the i-gel™ device
- Following insertion, the i-gel™ is stabilised against the base of the tongue by a ridge at the proximal end of the bowl
- The pressure applied to the base of the tongue may result in injury to the lingual nerve on the inferior surface of the tongue
- The i-gel™ is stabilised within the buccal cavity by a wide symmetrical tube stem
- This stem may result in injury to the lingual nerve on the lateral edge of the tongue
Implications:
- Use of the i-gel™ supraglottic airway device may result in damage to the lingual nerve
- As reported previously†, although damage to the lingual nerve may occur following the use of laryngeal masks with an inflatable cuff, this is a rare event