Great auricular neuropraxia with beach chair position

Abstract

Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position. The GAN, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. We recommend that for the procedures of the beach chair position, the auricle be protected and covered with cotton and gauze to avoid direct compression and the position of the head and neck be checked and corrected frequently.

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Keywords:

• neuropraxia
• anesthesia
• arthroscopy
• great auricular nerve

Acknowledgments

Written informed consent was obtained from the patient for publication of the case details. The authors thank Dr Joseph SchianodiCola, Chairman, Department of Anesthesiology, New York Methodist Hospital, for providing general support to write this paper.

Disclosure

The authors report no conflicts of interest in this work.