title: Vernet's syndrome after carotid endarterectomy.
abstract: Unilateral paresis of cranial nerves IX to XI is defined as Vernet's syndrome. We retrospectively assessed cranial nerve symptoms from the clinical records of 143 carotid endarterectomy patients. A flexible nasolaryngoscope was used to examine vocal fold movements in 73 patients. If vocal fold paresis (VFP) was confirmed, the patient also underwent magnifying laryngoscopy (for correct diagnosis of injury to the glossopharyngeal and vagus nerves). It was found from clinical records that 8 patients (6%) were confirmed to have cranial nerve symptoms corresponding to Vernet's syndrome; 7 patients (9 %) had VFP on nasolaryngoscopy. In 2 patients, magnifying laryngoscopy confirmed ipsilateral VFP, pharyngeal paresis, pharyngeal wall hypesthesia, and ipsilateral pharyngeal wall swelling. These 2 patients also had symptoms of injury to the accessory nerve. Damage to cranial nerves IX to XI probably occurred in the parapharyngeal space, based on the existence of posterior pharyngeal wall edema or swelling after carotid endarterectomy.
authors.affiliation: 1Nippon Medical School Tamanagayama Hospital, Tamashi, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Tamaki
authors.forename: Yoji
authors.initials: Y
authors.lastname: Node
authors.forename: Norihiro
authors.initials: N
authors.lastname: Saitoum
authors.forename: Hideto
authors.initials: H
authors.lastname: Saigusa
authors.forename: Michio
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Akio
authors.initials: A
authors.lastname: Morita
mesh_terms: D061227:Accessory Nerve Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D061287:Glossopharyngeal Nerve Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D061223:Vagus Nerve Injuries / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014826:Vocal Cord Paralysis / Q000209:etiology
keywords: carotid endarterectomy; cranial nerve; hoarseness; parapharyngeal space; vagus nerve