Cranial nerve injuries after carotid artery surgery. A prospective study of 663 operations.

OBJECTIVE

To establish the incidence of cranial nerve injuries caused by carotid artery surgery.

METHODS

During the years 1982 to 1992, 689 carotid artery operations were performed at Malmö General Hospital. Of these 656 were pre- and postoperatively examined at the Department of Phoniatrics concerning the function of the cranial nerves IX, X, and XII.

RESULTS

There was injury to one or more of the examined nerves after 75 operations (11.4%). In 70 (10.7%) operations the hypoglossal nerve was injured, in eight (1.2%) the recurrent laryngeal nerve, in two (0.3%) the glossopharyngeal nerve and in two (0.3%) the superior laryngeal nerve. Seven patients complained of postoperative hoarseness, but had no injuries. One hypoglossal and one recurrent nerve injury was permanent. Nerve injury was more frequent in operations performed with a shunt (p = 0.05), with patch closure (p = 0.01) and by a junior surgeon (p = 0.05).

CONCLUSION

In a prospective series, the incidence of cranial nerve injuries after carotid surgery was significant but the vast majority were reversible.