Cevik Orhun Mete, Usseli Murat Imre, Babur Mert, Unal Cansu, Eksi Murat Sakir, Guduk Mustafa, Ovalioglu Talat Cem, Aksoy Mehmet Emin, Pamir Mehmet Necmettin, Bozkurt Baran
Department of Neurosurgery, Acıbadem Mehmet Ali Aydinlar University, 34662 Istanbul, Turkey.
Department of Neurosurgery, Bakırkoy Training and Research Hospital for Psychiatric and Nervous Diseases, Health Sciences University, 34147 Istanbul, Turkey.
Brain Sci. 2021 Feb 10;11(2):211. doi: 10.3390/brainsci11020211.
Cerebral stroke continues to be one of the leading causes of mortality and long-term morbidity; therefore, carotid endarterectomy (CEA) remains to be a popular treatment for both symptomatic and asymptomatic patients with carotid stenosis. Cranial nerve injuries remain one of the major contributor to the postoperative morbidities. Anatomical dissections were carried out on 44 sides of 22 cadaveric heads following the classical CEA procedure to investigate the variations of the local anatomy as a contributing factor to cranial nerve injuries. Concurrence of two variations was found to be important in hypoglossal nerve injury: the presence of a direct smaller vein in proximity of the carotid bifurcation, and the intersection of the hypoglossal nerve (HN) with this vein. Based on the sample investigated, this variation was observed significantly higher on the right side. Awareness of possible anatomical variations and early ligation of any small veins can significantly decrease iatrogenic injury risk.
脑卒仍然是导致死亡和长期致残的主要原因之一；因此，颈动脉内膜切除术（CEA）仍然是治疗有症状和无症状颈动脉狭窄患者的常用方法。颅神经损伤仍然是术后致残的主要原因之一。按照经典的CEA手术方法，对22个尸头的44侧进行解剖，以研究局部解剖变异作为颅神经损伤的一个促成因素。发现两种变异同时出现对舌下神经损伤很重要：颈动脉分叉附近存在一条直接的较小静脉，以及舌下神经（HN）与该静脉的交叉。根据所研究的样本，这种变异在右侧的发生率明显更高。了解可能的解剖变异并尽早结扎任何小静脉可显著降低医源性损伤风险。
