Laryngeal and cranial nerve involvement after carotid endarterectomy

Laryngeal and/or cranial nerve involvement after CEA surgery is not a rare condition, occurring in almost half of operated subjects. However, in most cases the functional deficit is transient and does not need any particular form of treatment. In this study, specific rehabilitative procedures were needed in only a relatively small number of cases (9%). A routine ENT examination has also proved to be extremely useful for detecting slight functional deficits which may occur following CEA surgery, bearing in mind that possible permanent lesions may require a rehabilitative procedure.

To identify, by means of a careful otolaryngologic examination, the incidence and degree of cranial nerve deficit related to carotid endarterectomy (CEA), starting from the first postoperative days.

A consecutive cohort of patients with symptomatic and asymptomatic carotid artery stenosis who underwent CEA was carefully followed on the basis of possible laryngeal and/or cranial nerve involvement. An ENT examination was carried out preoperatively (phase I) and at different times [3 (phase II) and 15 days (phase IIIa)] after surgery; in addition, patients with persisting neurological lesions were also checked 60 days after surgery (phase IIIb).

In 59% of the patients, isolated or associated forms of deficit were found. Only 17.5% of these deficits did not appear to be transient, but rehabilitative procedures for voice or swallowing impairments were only needed in 9% of them.