Perioperative hypoglossal nerve palsy is a rare postoperative complication. Here, we present a case of transient unilateral hypoglossal nerve palsy after shoulder surgery. The cause of the hypoglossal nerve palsy in our patient was assumed to be a complication of oropharyngeal manipulation during orotracheal intubation for general anesthesia. However, direct compression of the hypoglossal nerve beneath the angle of the mandible during mask ventilation and the surgical procedure may have been a concomitant cause. Therefore, in order to prevent this complication, we must perform mask ventilation and direct laryngoscopy carefully. Head and neck manipulation should be gentle during anesthesia for shoulder surgery.
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