What are the possible cranial nerve injuries caused by carotid endarterectomy (CEA)?

Updated: Oct 24, 2019
  • Author: Sonia Nhieu, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Injury to the facial nerve (CN VII), the glossopharyngeal nerve (CN IX), the vagus nerve (CN X), the spinal accessory nerve (CN XI), the hypoglossal nerve (CN XII), or the great auricular nerve is possible during CEA. A meta-analysis of 26 articles, corresponding to a total of 20,860 CEAs, identified urgent procedures and return to the OR for a neurologic event or bleeding as predictors of CN injury. [19]  Other independent predictors include the following [21] :

  • Age greater than 80 years
  • Preoperative bleeding disorder
  • Longer operating time, with an adjusted odds ratio of 1.15 for each 30-minute interval beyond an operating time of 90 minutes

The meta-analysis by Kakisis et al found no statistically significant association between CN injury and the type of anesthesia used. [19]

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