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Case Reports in Anesthesiology
Volume 2019, Article ID 5392847, 8 pages
Case Report

Tongue Tied after Shoulder Surgery: A Case Series and Literature Review

1Mayo Clinic, Phoenix, AZ, USA
2Southwestern Colorado Ear, Nose & Throat Associates, Durango, CO, USA

Correspondence should be addressed to Molly B. Kraus; ude.oyam@yllom.suark

Received 21 March 2019; Accepted 23 June 2019; Published 29 October 2019

Academic Editor: Pavel Michalek

Copyright © 2019 Molly B. Kraus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This article presents three cases of cranial nerve palsy following shoulder surgery with general anesthesia in the beach chair position. All patients underwent preoperative ultrasound-guided interscalene nerve block. Two cases of postoperative hypoglossal and one case of combined hypoglossal and recurrent laryngeal nerve palsies (Tapia’s syndrome) were identified. Through this case series, we provide a literature review identifying postoperative cranial nerve palsies in addition to the discussion of possible etiologies. We suggest that intraoperative patient positioning and/or airway instrumentation is most likely causative. We conclude that the beach chair position is a risk factor for postoperative hypoglossal nerve palsy and Tapia’s syndrome.