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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2000 September;19(3):237-241

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Cranial nerve dysfunction following carotid endarterectomy

Maroulis J., Karkanevatos A., Papakostas K., Gilling-Smith G. L., McCormick M. S., Harris P. L.

From the Departments of Vascular Surgery and * Otolaryngology Royal Liverpool University Hospital, Liverpool, UK


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Back­ground. Carot­id endar­te­rec­to­my (CEA) is the most com­mon sur­gi­cal pro­ce­dure per­formed for the treat­ment of symp­to­mat­ic carot­id sten­o­sis great­er than 70%. Among the rec­og­nised com­pli­ca­tions, such as ­stroke and myo­car­dial infarc­tion, is inju­ry to cra­ni­al ­nerves.
Meth­ods. We ­report the inci­dence and fol­low-up of cra­ni­al nerve inju­ry in 269 ­patients who under­went carot­id endar­te­rec­to­my ­between Jan­u­ary 1994 and Decem­ber 1997 at the Royal Liv­er­pool Uni­ver­sity Hos­pi­tal.
­Results. Fif­teen cra­ni­al nerve inju­ries were doc­u­ment­ed (5.6%). Seven ­patients (2.6%) had uni­lat­er­al vocal cord par­al­y­sis, nine (3.3%) hypo­glos­sal palsy, two (0.7%) glos­soph­a­ryn­geal nerve inju­ry and one (0.4%) ­facial nerve palsy (mar­gi­nal man­dib­u­lar nerve). All ­patients ­showed improve­ment with­in a few weeks and none had resid­u­al dis­abil­ity at the last fol­low-up (two weeks to 14 ­months).
Con­clu­sions. ­Patients man­i­fest­ing symp­toms of cra­ni­al nerve dys­func­tion ­should under­go a ­thorough otol­a­ryn­go­log­i­cal eval­u­a­tion and long-term fol­low-up. Most cra­ni­al nerve inju­ries are tran­sient and ­result from trau­ma dur­ing dis­sec­tion, retrac­tion or carot­id clamp­ing. Knowl­edge of cra­ni­al nerve anat­o­my is essen­tial if the sur­geon is to avoid such inju­ries.

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