Vernet's syndrome after carotid endarterectomy
Tomonori Tamaki1, Yoji Node, Norihiro Saitoum
11Nippon Medical School Tamanagayama Hospital, Tamashi, Japan.
Perspectives in Vascular Surgery and Endovascular Therapy
|March 15, 2014
Summary
Vernet's syndrome, characterized by cranial nerve IX-XI paresis, was assessed in carotid endarterectomy patients. Some patients developed vocal fold paresis and other cranial nerve deficits, likely due to parapharyngeal space injury.
Area of Science:
- Neurology
- Otolaryngology
- Vascular Surgery
Background:
- Vernet's syndrome involves unilateral paresis of cranial nerves IX, X, and XI.
- Carotid endarterectomy is a surgical procedure to remove plaque from carotid arteries.
Purpose of the Study:
- To assess the incidence of Vernet's syndrome and related cranial nerve symptoms post-carotid endarterectomy.
- To investigate the potential location of nerve damage in the parapharyngeal space.
Main Methods:
- Retrospective review of 143 carotid endarterectomy patient records.
- Flexible nasolaryngoscopy to evaluate vocal fold movement in 73 patients.
- Magnifying laryngoscopy for detailed diagnosis of glossopharyngeal and vagus nerve injury.
Main Results:
- 8 patients (6%) exhibited symptoms consistent with Vernet's syndrome.
- 7 patients (9%) showed vocal fold paresis (VFP) on nasolaryngoscopy.
- 2 patients had confirmed VFP, pharyngeal paresis, hypesthesia, and swelling, indicating accessory nerve injury.
Conclusions:
- Cranial nerve deficits, including Vernet's syndrome, can occur after carotid endarterectomy.
- Damage to cranial nerves IX-XI likely results from injury within the parapharyngeal space, potentially indicated by pharyngeal wall swelling.
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