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Pharyngeal function after carotid endarterectomy.

O Ekberg, D Bergqvist, R Takolander

    Dysphagia
    |January 1, 1989
    PubMed
    Summary
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    Carotid endarterectomy can cause temporary pharyngeal dysfunction, affecting swallowing and laryngeal closure. Monitoring patients post-surgery is crucial for those at risk of these neurologic deficits.

    Area of Science:

    • Neurology
    • Otolaryngology
    • Vascular Surgery

    Background:

    • Neurologic deficiencies can impact pharyngeal function, affecting swallowing and airway protection.
    • Carotid endarterectomy is a surgical procedure to remove plaque from the carotid artery, potentially affecting nearby nerves and structures.

    Purpose of the Study:

    • To prospectively investigate the incidence and nature of pharyngeal dysfunction after carotid endarterectomy.
    • To identify risk factors associated with postoperative pharyngeal dysfunction.

    Main Methods:

    • Prospective study of 12 patients undergoing carotid endarterectomy.
    • Cineradiography used to monitor pharyngeal function pre- and post-operatively.
    • Assessment of pharyngeal function at 1 and 4 weeks after surgery.

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    Main Results:

    • Five patients (42%) developed pharyngeal dysfunction, including impaired laryngeal vestibule closure, epiglottic dysmotility, and pharyngeal constrictor paresis.
    • Dysfunction persisted in 2 patients at 4 weeks, while 3 showed resolution.
    • Pharyngeal dysfunction was more frequent in patients with preoperative minor stroke, perioperative carotid shunting, and longer operation times.

    Conclusions:

    • Transient pharyngeal dysfunction is a potential complication of carotid endarterectomy.
    • Cervical structure manipulation or cerebrovascular injury may cause this dysfunction.
    • Close postoperative monitoring of oral and pharyngeal function is recommended for at-risk patients.