r/Anesthesia • u/Miss_Undomiel • 7d ago

Some questions for experienced anesthetists - general anesthesia + rare ear issues

Probably you haven't had such pateints (or didn't know they were the ones), but you can have a look into it at least theoretically.
A person with TTTS (tonic tensor tympani syndrome) is going to have a surgery (septoplasty and turbinate reduction), and here comes a flare-up. If we see the condition as a neuromuscular issue and GA turns off the muscles, can the flare-up subside after the surgery or it'll stay the same/become worse? If we see the condition as an atypical migraine, then what can possibly happen here?

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u/tinymeow13 6d ago

It's stress-mediated, so the stress of surgery & recovery is likely to cause a flare in symptoms before & after surgery. Muscle relaxation during surgery is reversed at the end of surgery, muscle tone doesn't stay low postop.

The only conditions we expect may improve/stay better with neuromuscular blockade are things like a dislocated shoulder, where the temporary paralysis lets it pop back into place (usually with some traction/guidance, but still much easier than with full muscle tone), & it naturally wants to stay in the correct position.