Local neurological complication during carotid endarterectomy.
In a prospective study of 52 carotid endarterectomies there were 13 temporary cranial nerve injuries in 12 patients (25%); 7 hypoglossal nerve injuries (13.5%), 3 were asymptomatic (5.8%), 2 had mild speech difficulty (3.8%) and 2 had severe difficulty with deglutition and articulation (3.8%). A full recovery was made within 3 months in all 7 patients. Although 10 patients (19.2%) developed a hoarse voice, indirect laryngoscopy only indicated damage to the ipsilateral recurrent laryngeal nerve in 3 patients (5.8%). Both the voice and vocal cord movement returned to normal within 6 months in 2 patients and a 9 months in the third. The marginal mandibular branch of the facial nerve was injured in 3 patients (5.8%) and all recovered completely within 3 months. Following injury to the great auricular and the transverse cervical nerves injury, 13 patients (25%) had persistent irritation and paraesthesia during shaving and in cold weather lasting up to 18 months after operation. Carotid endarterectomy is associated with a much higher incidence of local nerve injury than retrospective surveys would indicate.
Department of Surgery, Bristol Royal Infirmary, U.K.
M I
MI
Aldoori
R N
RN
Baird
D000368:Aged; D002340:Carotid Artery Diseases / Q000601:surgery*; D020209:Cranial Nerve Injuries; D004691:Endarterectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D061228:Hypoglossal Nerve Injuries; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000294:innervation; D011446:Prospective Studies; D061226:Recurrent Laryngeal Nerve Injuries; D012867:Skin / Q000294:innervation