{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:53:20Z","timestamp":1761648800140},"reference-count":20,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nSuperior laryngeal nerve block (SUPLANEB) is a popular airway anesthesia technique utilized for successful awake endotracheal intubation in patients with significant cervical spine instability. If not performed by an expert, it carries the risk of general\/neurologic complications that are typically minimal\/transient. However, permanent blindness and\/or upper cranial nerve neuropathies may occur. Here, we describe a case in which a young patient underwent an atlantoaxial fusion for a C2 nonunion (e.g., following a fracture) complicated by unilateral blindness due to a SUPLANEB.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 25-year-old neurologically intact male underwent a C1-C2 posterior arthrodesis to address a nonunion of a C2 fracture. To perform the awake nasotracheal intubation, a SUPLANEB was performed using a video laryngoscope. Although the operation was uneventful, postoperatively, the patient reported left visual loss accompanied by left-sided facial numbness and hearing loss. On examination of the left eye, the anterior segment and fundus examinations were normal, but the OCT (optical coherence tomography) and retinal angiography demonstrated left-sided postischemic retinal edema with permeability of the intraocular vessels. Although the cranio-orbital computed tomography scan showed only mild pneumocephalus, the CT angiogram scan revealed abnormal air in the left carotid sheath accompanied by diffuse subcutaneous emphysema. Further, brain and orbital magnetic resonance imaging scans were normal. The patient was treated with pure oxygen, systemic steroid therapy, and nimodipine. The pneumocephalus and subcutaneous emphysema resolved on day 3. At 2 months follow-up, the patient remained blind on the left side, but had no further neurological deficits.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nBlindness and upper cranial nerves neuropathies should be considered as potential complications of SUPLANEB. Notably, these deficits were not directly related to the operative positioning or neurosurgical spinal procedure.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_505_2020","type":"journal-article","created":{"date-parts":[[2020,9,5]],"date-time":"2020-09-05T06:43:15Z","timestamp":1599288195000},"page":"277","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Unilateral blindness following superior laryngeal nerve block for awake tracheal intubation in a case of posterior cervical spine surgery"],"prefix":"10.25259","volume":"11","author":[{"given":"Ali","family":"Akhaddar","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V University, Rabat, Morocco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Baallal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V University, Rabat, Morocco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabil","family":"Hammoune","sequence":"additional","affiliation":[{"name":"Department of Radiology, Avicenne Military Hospital of Marrakech, Mohammed V University, Rabat, Morocco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salaheddine","family":"Bouabbadi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Avicenne Military Hospital of Marrakech, Mohammed V University, Rabat, Morocco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amine","family":"Adraoui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V University, Rabat, Morocco."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatim","family":"Belfquih","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V University, Rabat, Morocco."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,9,5]]},"reference":[{"key":"10.25259\/SNI_505_2020\/ref-1","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.spinee.2012.02.007","article-title":"Subconjunctival hemorrhage as a complication of intraoperative positioning for lumbar spinal surgery","volume":"12","author":"Akhaddar","year":"2012","journal-title":"Spine J"},{"key":"10.25259\/SNI_505_2020\/ref-2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/00008506-199607000-00007","article-title":"Unilateral blindness due to patient positioning during cervical syringomyelia surgery: Unilateral blindness after prone position","volume":"8","author":"Bekar","year":"1996","journal-title":"J Neurosurg Anesthesiol"},{"key":"10.25259\/SNI_505_2020\/ref-3","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1056\/NEJM199109193251207","article-title":"Transient monocular blindness caused by vasospasm","volume":"325","author":"Burger","year":"1991","journal-title":"N Engl J Med"},{"key":"10.25259\/SNI_505_2020\/ref-4","doi-asserted-by":"crossref","first-page":"E24","DOI":"10.1097\/01.ta.0000229049.11274.96","article-title":"Pneumocephalus in the absence of craniofacial skull base fracture","volume":"66","author":"Choi","year":"2009","journal-title":"J Trauma"},{"key":"10.25259\/SNI_505_2020\/ref-5","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s10140-018-1595-x","article-title":"Causes of pneumocephalus and when to be concerned about it","volume":"25","author":"Cunqueiro","year":"2018","journal-title":"Emerg Radiol"},{"key":"10.25259\/SNI_505_2020\/ref-6","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.anclin.2015.02.013","article-title":"Airway anesthesia: Theory and practice","volume":"33","author":"Doyle","year":"2015","journal-title":"Anesthesiol Clin"},{"key":"10.25259\/SNI_505_2020\/ref-7","doi-asserted-by":"crossref","first-page":"S347","DOI":"10.4103\/2152-7806.182550","article-title":"Perioperative visual loss following prone spinal surgery: A review","volume":"7","author":"Epstein","year":"2016","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_505_2020\/ref-8","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.amjoto.2013.08.009","article-title":"Neurologic toxicity of lidocaine during awake intubation in a patient with tongue base abscess. 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