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Local neurological complication during carotid endarterectomy
1Department of Surgery, Bristol Royal Infirmary, U.K.
The Journal of Cardiovascular Surgery
|July 1, 1988
Summary
Carotid endarterectomy can cause temporary cranial nerve injuries, including hypoglossal and recurrent laryngeal nerves, impacting speech and voice. Most patients recover within months, but some experience persistent sensory issues.
Area of Science:
- Neurology
- Vascular Surgery
Background:
- Carotid endarterectomy is a common procedure to prevent stroke.
- The incidence of local nerve injury following this surgery is not well-documented.
Purpose of the Study:
- To prospectively evaluate the incidence of temporary and persistent cranial nerve injuries after carotid endarterectomy.
- To characterize the types of nerve injuries and their recovery patterns.
Main Methods:
- Prospective study of 52 patients undergoing carotid endarterectomy.
- Detailed recording of all temporary and persistent nerve injuries and their clinical manifestations.
- Follow-up assessments to determine recovery timelines.
Main Results:
- 13 temporary cranial nerve injuries (25%) occurred in 12 patients.
- Hypoglossal nerve injuries (13.5%) led to temporary speech and swallowing difficulties.
- Recurrent laryngeal nerve injuries (5.8%) caused hoarseness, with most recovering within 6-9 months.
- Marginal mandibular nerve injuries (5.8%) resolved within 3 months.
- Great auricular and transverse cervical nerve injuries resulted in persistent sensory issues in 25% of patients up to 18 months.
Conclusions:
- Carotid endarterectomy is associated with a higher incidence of local nerve injury than previously reported.
- Most nerve injuries are temporary, but some can lead to persistent sensory disturbances.
- Prospective evaluation is crucial for accurate assessment of surgical complications.