Highlights • The robotic surgery is a creative and effective technique; however, the risk of this technique has not been fully documented. • We describe neurological complication of hypoglossal nerve palsy after robotic thyroidectomy. • Hypoglossal nerve palsy is usually presented with tongue deviation, atrophy and dysarthria. • Nerve conduction study (NCS) can be used to confirm the hypoglossal nerve injury.
Background Endoscopic surgical techniques with robotic system in the thyroid cancer have been reported to show good results and advantages; however the risk of these techniques has not been fully documented. Presentation of the case We experienced an uncommon complicated case of a 20-year-old woman with a papillary thyroid carcinoma. After the robotic thyroidectomy, she complained of the tongue deviation, speech and swallowing difficulties of hypoglossal nerve palsy. Discussion In this case, a few etiologies could be suggested for the development of hypoglossal nerve palsy. It might be associated with direct stretching or entrapment of hypoglossal nerve during tumor resection; lateral placement of the laryngoscope on the tongue base; the hyperinflation of the laryngeal mask airway; and histological disruption of the intraneural connective tissue and blood circulation. Conclusion Although the robotic surgery is a creative technique and has been known to be safe and effective, the risk of this surgery including traumatic nerve injury should be taken into account before surgery.