A prospective study of the incidence of injury to the cranial nerves during carotid endarterectomy.

In order to determine the incidence of cranial nerve injury during carotid endarterectomy, preoperative and postoperative otolaryngologic examinations were performed in a prospective series of 240 operations. Thirty patients experienced a total of 38 cranial nerve injuries, involving the recurrent laryngeal nerve in 14, the hypoglossal nerve in 13, the marginal mandibular nerve in six and the superior laryngeal nerve in five. Postoperative dysfunction affected one cranial nerve in 25 patients, two nerves in four and three nerves in one patient. Most cranial nerve injuries were asymptomatic or mild in severity, resolved in one to 12 months and probably were caused by intraoperative retraction.