Intraoperative transcranial Doppler ultrasound in head and neck surgery: a preliminary report.
OBJECTIVE
To evaluate the possible role of intraoperative cerebral emboli in the origin of perioperative stroke during major head and neck surgical procedures.


METHODS
Eleven patients undergoing major head and neck surgery that involved direct manipulation of the carotid sheath were the participants in this study. Transcranial Doppler (TCD) ultrasound was used intraoperatively to detect possible cerebral emboli. The presence or absence of intraoperative cerebral emboli in each patient was assessed by the presence or absence of typical embolic signal patterns within the TCD waveform.


RESULTS
No intraoperative cerebral emboli were noted in the series, nor did any patient have a postoperative stroke.


CONCLUSIONS
No intraoperative cerebral emboli were noted by using TCD ultrasound for embolus monitoring in patients undergoing major head and neck surgery involving carotid sheath manipulation. This detection system is easily used in appropriate head and neck cases and allows real-time, noninvasive intraoperative monitoring.
Department of Otolaryngology-Head and Neck Surgery, St Louis University Health Sciences Center, MO, USA.
D K
DK
Nosan
C R
CR
Gomez
J H
JH
Boyd
K E
KE
Boone
M D
MD
Maves
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000209:etiology; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D037981:Neck Dissection / Q000009:adverse effects*; D010865:Pilot Projects; D017585:Ultrasonography, Doppler, Transcranial