Cranial Nerve Injury Associated with Surgery of the Carotid System

Abstract

Injury of the cranial nerves during surgery of the carotid system is a rela tively common problem. The damage often escapes the attention of the surgeon, and its severity and consequences for the patient are not usually properly evalu ated. In this study the authors examined the immediate postoperative status of the cranial nerves in 404 patients who underwent 519 operative procedures for a variety of conditions affecting the carotid artery system. The authors identified 13 instances of injury (2.5%) 4 of which were perma nent (0.8%) and 9 transient (1.7%). The hypoglossal nerve was permanently injured in 2 instances (0.4%) and the recurrent laryngeal nerve in another 2 (0.4%). In 6 instances (1.2%) the injury to the hypoglossal was transient, as it was in 3 instances of recurrent laryngeal nerve injury (0.6%).