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Cranial nerve injuries during carotid endarterectomy
F W Knight1, R M Yeager, D M Morris
1Department of Surgery, Louisiana State University School of Medicine, Shreveport.
American Journal of Surgery
|November 1, 1987
Summary
Carotid endarterectomy can cause nerve injuries, including vocal cord paralysis and hoarseness, in 9.3% of patients. Most cranial nerve injuries during this procedure are temporary and result from surgical trauma.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Otolaryngology
Background:
- Carotid endarterectomy is a common procedure to prevent stroke.
- Cranial nerve injuries are a potential complication of carotid endarterectomy.
- The exact incidence and nature of these injuries require further investigation.
Purpose of the Study:
- To retrospectively review the incidence and types of nerve injuries in patients undergoing carotid endarterectomy.
- To analyze the characteristics and outcomes of these nerve injuries.
- To discuss prevention strategies for cranial nerve injuries during the procedure.
Main Methods:
- Retrospective review of 129 carotid endarterectomies performed on 112 patients over a 10-year period.
- Identification of nerve injuries through postoperative progress and clinic note review.
- Documentation of vocal cord paralysis using indirect laryngoscopy.
Main Results:
- 12 out of 112 patients (9.3%) sustained major nerve injuries.
- Injuries included vagal nerve (5), marginal mandibular nerve (4), and hypoglossal nerve (3).
- No nerve injury patients experienced a stroke post-operatively; most injuries were transient and attributed to surgical trauma.
Conclusions:
- The incidence of cranial nerve injury during carotid endarterectomy may be higher than previously reported.
- Most injuries are transient and likely caused by dissection, retraction, or clamping, not transection.
- Understanding anatomy and employing preventative techniques are crucial for minimizing nerve damage.