Cranial nerve dysfunction following carotid endarterectomy.
BACKGROUND
Carotid endarterectomy (CEA) is the most common surgical procedure performed for the treatment of symptomatic carotid stenosis greater than 70%. Among the recognised complications, such as stroke and myocardial infarction, is injury to cranial nerves.


METHODS
We report the incidence and follow-up of cranial nerve injury in 269 patients who underwent carotid endarterectomy between January 1994 and December 1997 at the Royal Liverpool University Hospital.


RESULTS
Fifteen cranial nerve injuries were documented (5.6%). Seven patients (2.6%) had unilateral vocal cord paralysis, nine (3.3%) hypoglossal palsy, two (0.7%) glossopharyngeal nerve injury and one (0.4%) facial nerve palsy (marginal mandibular nerve). All patients showed improvement within a few weeks and none had residual disability at the last follow-up (two weeks to 14 months).


CONCLUSIONS
Patients manifesting symptoms of cranial nerve dysfunction should undergo a thorough otolaryngological evaluation and long-term follow-up. Most cranial nerve injuries are transient and result from trauma during dissection, retraction or carotid clamping. Knowledge of cranial nerve anatomy is essential if the surgeon is to avoid such injuries.
Maroulis
J
J
Department of Vascular Surgery, Royal Liverpool University Hospital, UK.
Karkanevatos
A
A
Papakostas
K
K
Gilling-Smith
G L
GL
McCormick
M S
MS
Harris
P L
PL
D000368:Aged; D016893:Carotid Stenosis / Q000601:surgery*; D003389:Cranial Nerve Diseases / Q000453:epidemiology / Q000209:etiology*; D020209:Cranial Nerve Injuries / Q000453:epidemiology / Q000209:etiology*; D016894:Endarterectomy, Carotid; D004739:England; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012075:Remission, Spontaneous; D012189:Retrospective Studies