Vol.100 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 4 April 2007
A Case of Cervical and Mediastinal Hematoma and Airway Obstruction
Following Stellate Ganglion Block: Accompanied by an Unusual
Course of Vertebral Artery
Masaomi Moriyama and Masashi Suzuki
(Oita University)
Jun Shutou
(Kenkouhoken Nankai Hospital)
It is well known that there are many complications in stellate ganglion block (SGB), but many of them are transient. Delayed severe airway obstruction due to hematoma following SGB is rare. We encountered a case of cervical, mediastinal hematoma and severe airway obstruction after SGB which had been performed for a 28-year old man with facial paralysis. On the day of the 3rd treatment, 4.5 hours after SGB, he suffered severe dyspnea. Cricothyrotomy was performed. Computed tomography revealed a large soft tissue mass extending in the retropharyngeal space from the cervical to mediastinal part. This soft tissue mass consisted of hematoma. We drained hematoma surgically, resulting in a good outcome with no complications. This case accompanied an unusual course of the vertebral artery. We speculated that the needle for SGB injured the vertebral artery and these caused massive hemorrhage in the retropharyngeal space.
Key words : cervical and mediastinal hematoma, airway obstruction, stellate ganglion block, unusual course of vertebral artery