Department of surgery, Medical College of Hallym University.
The great auricular nerve injuries after the rhytidectomy, parotidectomy, mastoidectomy or in inserting the central venous line were previously reported. But great auricular nerve injury after the ventriculoperitoneal shunt operation was rarely reported. We reported one case of great auricular nerve injury after the ventriculoperitoneal shunt in traumatic brain injured patient. A 32 year-old man sufferred from pain on right earlobe following a ventriculoperitoneal shunt operation for obstructive hydrocephalus 4 months before visiting our service. Shock-like paresthesia could be triggered by touching or palpating the distribution of the right great auricular nerve, Nerve conduction study using averaging 30 responses revealed decreasing amplitude(peak to peak) of right great auricular nerve to 12㎶ and slowing latency to 2.8msec compared to 25㎶ and 2.0msec relation on the left side.
The great auricular nerve injury could be frequently occurred because of its anatomical pathway of mid-point of sternocleidomastoid music belly superficially crossing the course of ventriculoperitoneal shunt line. The great auricular nerve conduction study was helpful to identify the involvement in this case. Physicians need to be aware of the risk of injury of great auricular nerve after the ventriculoperitoneal shunt operation.
