Lin Harrison W, Rho Michael B, Amin-Hanjani Sepideh, Barker Fred G, Deschler Daniel G
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Skull Base. 2009 Sep;19(5):369-73. doi: 10.1055/s-0029-1220204.
Head and neck cancer patients with cervical disease involving the glossopharyngeal or vagus nerves can experience dangerous cardiovascular phenomena, including carotid sinus syncope (CSS). Medical and minimally invasive interventions, including pacemaker placement, incompletely address the etiologies of syncopal episodes and therefore often provide limited benefit. The objectives of this report are to highlight the difficulties of managing cancer-related CSS, to present a highly effective surgical intervention, and to review the literature regarding the pathophysiology and treatment options for patients with cancer-related CSS. Two patients with cancer-related CSS continued to experience syncopal episodes despite medical and pacemaker therapy. Consequently, these patients underwent a suboccipital craniotomy for glossopharyngeal and limited vagal neurectomy. After surgery, both patients had uncomplicated postoperative courses with resolution of syncope.
患有累及舌咽神经或迷走神经的颈部疾病的头颈癌患者可能会出现危险的心血管现象，包括颈动脉窦晕厥（CSS）。包括起搏器植入在内的药物和微创干预措施并不能完全解决晕厥发作的病因，因此往往益处有限。本报告的目的是强调管理癌症相关CSS的困难，介绍一种高效的手术干预方法，并回顾有关癌症相关CSS患者的病理生理学和治疗选择的文献。两名患有癌症相关CSS的患者尽管接受了药物和起搏器治疗，但仍持续出现晕厥发作。因此，这些患者接受了枕下开颅手术以进行舌咽神经和有限的迷走神经切除术。手术后，两名患者术后过程均无并发症，晕厥症状得以缓解。
