scholarly journals Cranial Nerve Injuries and the Retrojugular Approach in Carotid Endarterectomy

2008 ◽  
Vol 90 (8) ◽  
pp. 685-688 ◽  
Author(s):  
William D Beasley ◽  
Christopher P Gibbons
Keyword(s):  
Carotid Endarterectomy ◽  
Cranial Nerve ◽  
Statistical Significance ◽  
Cranial Nerves ◽  
Case Series ◽  
Surgical Approaches ◽  
Nerve Injuries ◽  
Retrospective Case ◽  
Significant Difference ◽  
Cranial Nerve Injuries

INTRODUCTION This is a retrospective case series analysis to compare the incidence of cranial nerve injuries in carotid endarterectomy by the retrojugular and anteromedial approaches. PATIENTS AND METHODS Data were extracted from a prospectively collected database. Ninety-one retrojugular carotid endarterectomies were compared with 145 anteromedial carotid endarterectomies. All were performed under local anaesthesia and used the eversion technique. Data were analysed using the chi-squared test. RESULTS Nine (3.8%) cases were complicated by cranial nerve injuries. In four cases, multiple nerves were involved. In total, 13 (5.5%) cranial nerves were injured. The affected nerves were: two (0.8%) marginal mandibular, two (0.8%) laryngeal, three (1.2%) accessory and six (2.5%) hypoglossal. There was no statistically significant difference in total or specific cranial nerve injuries between the two surgical approaches. CONCLUSIONS The risk of cranial nerve injuries was similar following either the retrojugular or anteromedial approach. Accessory nerve injuries were only seen in the retrojugular approach but this did not reach statistical significance.

Risk of persistent cranial nerve injury after carotid endarterectomy

2004 ◽  
Vol 101 (3) ◽  
pp. 445-448 ◽  
Author(s):  
Edwin J. Cunningham ◽  
Rick Bond ◽  
Marc R. Mayberg ◽  
Charles P. Warlow ◽  
Peter M. Rothwell
Keyword(s):  
Carotid Endarterectomy ◽  
Nerve Injury ◽  
Cranial Nerve ◽  
Nerve Injuries ◽  
Content Type ◽  
Before And After ◽  
Cranial Nerve Injury ◽  
Cranial Nerve Injuries ◽  
Fine Print

Object. Cranial nerve injuries, particularly motor nerve injuries, following carotid endarterectomy (CEA) can be disabling and therefore patients should be given reliable information about the risks of sustaining such injuries. The reported frequency of cranial nerve injury in the published literature ranges from 3 to 23%, and there have been few series in which patients were routinely examined before and after surgery by a neurologist. Methods. The authors investigated the risk of cranial nerve injuries in patients who underwent CEA in the European Carotid Surgery Trial (ECST), the largest series of patients undergoing CEA in which neurological assessment was performed before and after surgery. Cranial nerve injury was assessed and recorded in every patient and persisting deficits were identified on follow-up examination at 4 months and 1 year after randomization. Risk factors for cranial nerve injury were examined by performing univariate and multivariate analyses. There were 88 motor cranial nerve injuries among the 1739 patients undergoing CEA (5.1% of patients; 95% confidence interval [CI] 4.1–6.2). In 23 patients, the deficit had resolved by hospital discharge, leaving 3.7% of patients (95% CI 2.9–4.7) with a residual cranial nerve injury: 27 hypoglossal, 17 marginal mandibular, 17 recurrent laryngeal, one accessory nerve, and three Horner syndrome. In only nine patients (0.5%; 95% CI 0.24–0.98) the deficit was still present at the 4-month follow-up examination; however, none of the persisting deficits resolved during the subsequent follow up. Only duration of operation longer than 2 hours was independently associated with an increased risk of cranial nerve injury (hazard ratio 1.56, p < 0.0001). Conclusions. The risk of motor cranial nerve injury persisting beyond hospital discharge after CEA is approximately 4%. The vast majority of neurological deficits resolve over the next few months, however, and permanent deficits are rare. Nevertheless, the risk of cranial nerve injury should be communicated to patients before they undergo surgery.

Literature Review of Cranial Nerve Injuries During Carotid Endarterectomy

2007 ◽  
Vol 107 (1) ◽  
pp. 25-28 ◽  
Author(s):  
M.S. Sajid ◽  
B. Vijaynagar ◽  
P. Singh ◽  
G. Hamilton
Keyword(s):  
Literature Review ◽  
Carotid Endarterectomy ◽  
Cranial Nerve ◽  
Nerve Injuries ◽  
Cranial Nerve Injuries

scholarly journals Prevention of Cranial Nerve Injuries during Carotid Endarterectomy

1997 ◽  
Vol 6 (9) ◽  
pp. 598-603
Author(s):  
Yoshinori Akiyama ◽  
Nobuo Hashimoto ◽  
Tetsuya Tsukahara ◽  
Toru Iwama ◽  
Shogo Nishi ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Cranial Nerve ◽  
Nerve Injuries ◽  
Cranial Nerve Injuries

scholarly journals Mucosal Thickening Occurs in Contralateral Paranasal Sinuses following Sinonasal Malignancy Treatment

2017 ◽  
Vol 78 (04) ◽  
pp. 331-336 ◽  
Author(s):  
Alice Maxfield ◽  
Kyle Chambers ◽  
Ahmad Sedaghat ◽  
Derrick Lin ◽  
Stacey Gray
Keyword(s):  
Paranasal Sinuses ◽  
Statistical Significance ◽  
Case Series ◽  
Time Lapse ◽  
Concurrent Chemotherapy ◽  
Retrospective Case ◽  
Sinonasal Malignancy ◽  
Academic Center ◽  
Significant Difference ◽  
Mucosal Thickening

Objective To investigate the incidence and degree of contralateral sinus disease following treatment of sinonasal malignancy (SNM) using radiological findings as an outcome measure. Study Design Retrospective case series. Setting Tertiary referral academic center. Participants Patients with SNM treated with surgical and adjuvant radiotherapy with or without concurrent chemotherapy. Main Outcome Measures Pre- and posttreatment computed tomography and magnetic resonance imaging scans, Lund–Mackay (LM) score, date of diagnosis, chemotherapy, and dosage of radiation therapy (RT). Results There was a significant difference between pre- and posttreatment LM scores (p < 0.001) of the contralateral paranasal sinuses. There was no statistical significance between the change in pre- and posttreatment LM scores and patient age, gender, chemotherapy, RT dosage, and time lapse between diagnosis and when we performed this study in the univariate and the multivariable analyses. Conclusions Following treatment of SNM with surgical resection and RT, there was a significant increase in incidence and degree of mucosal thickening of the contralateral sinus by LM grading that persisted after the completion of treatment. This indicates the need for long-term follow-up to monitor for chronic rhinosinusitis as a delayed complication following treatment of SNM.

Cranial nerve injuries during carotid endarterectomy

1987 ◽  
Vol 154 (5) ◽  
pp. 529-532 ◽  
Author(s):  
Frederick W. Knight ◽  
Rod M. Yeager ◽  
Don M. Morris
Keyword(s):  
Carotid Endarterectomy ◽  
Cranial Nerve ◽  
Nerve Injuries ◽  
Cranial Nerve Injuries
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