Maroulis J, Karkanevatos A, Papakostas K, Gilling-Smith G L, McCormick M S, Harris P L
Department of Vascular Surgery, Royal Liverpool University Hospital, UK.
Int Angiol. 2000 Sep;19(3):237-41.
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.
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.
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).
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.
颈动脉内膜切除术（CEA）是治疗症状性颈动脉狭窄超过70%最常用的外科手术。在已确认的并发症中，如中风和心肌梗死，还包括颅神经损伤。
我们报告了1994年1月至1997年12月在皇家利物浦大学医院接受颈动脉内膜切除术的269例患者的颅神经损伤发生率及随访情况。
记录到15例颅神经损伤（5.6%）。7例患者（2.6%）出现单侧声带麻痹，9例（3.3%）舌下神经麻痹，2例（0.7%）舌咽神经损伤，1例（0.4%）面神经麻痹（下颌缘支神经）。所有患者在几周内均有改善，最后一次随访（2周至14个月）时均无残留残疾。
出现颅神经功能障碍症状的患者应接受全面的耳鼻喉科评估及长期随访。大多数颅神经损伤是短暂的，由解剖、牵拉或颈动脉夹闭过程中的创伤引起。外科医生若要避免此类损伤，了解颅神经解剖结构至关重要。
