Assessment of frequency of cranial nerve lesions after carotid artery surgery
Journal Title: Серце і судини - Year 2019, Vol 0, Issue 1
Abstract
The aim — to improve the methods of treatment of carotid pathology by analyzing the frequency of the cranial nerves’ lesions through generalization of the literary sources and the results of own observations. Materials and methods. A review of the latest world‑wide‑scale studies (NYCAS, ECST, NASCET, CREST, VSGNE) and analysis of statistical data, dedicated the problem of cranial nerves’ lesions after surgical interventions on the carotid arteries, was conducted. The frequency of cranial nerves’ lesions was retrospectively analyzed in the total number of operations on brachiocephalic arteries at vascular surgery department of Lviv Regional Clinical Hospital for the period from 2008 — 2017 years (1373 operations). The presence of stable or transient cranial nerves’ lesions in the early and late postoperative period was documented by the neuropathologist and the otolaryngologist. Results and discussion. According to world statistical studies, the frequency of cranial nerves’ lesions after surgical interventions on the carotid arteries is 3 — 27 %, according to the European Association of Vascular Surgeons — 5.1 %. The results of American studies are closed to this value: NYCAS — 5.5 %, NASCET — 8.6 % and CREST — 4.7 %. The most frequently injured are: n. hypoglossus, n. glossopharyngeus and n. auricularis magnus. At vascular surgery department of Lviv Regional Clinical Hospital, the frequency of cranial nerves’ lesions after surgical interventions on the carotid arteries was 7.2 %. The most frequent were injuries of n. vagus, n. hypoglossus and n. glossopharyngeus. Clinical symptoms of injury largely regressed during 1 year. In the cases of atherosclerotic lesions of carotid arteries, the higher rates of postoperative neurological symptoms were observed among symptomatic patients in comparison with asymptomatic ones. Conclusions. The frequency of cranial nerves’ lesions according to the data of literary sources is within the range of 3—27 %. N. vagus, n. hypoglossus, and n. glossopharyngeus have highest rate of frequency of the lesion after surgical intervention on the carotid arteries. The injury process is largely reversible within one year after surgery.
Authors and Affiliations
Т. I. Kobza
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