MOTOR SPEECH MALFUNCTION FOLLOWING CAROTID ENDARTERECTOMY

  • 1 January 1981
    • journal article
    • research article
    • Vol. 89  (1) , 56-59
Abstract
Cranial nerve injury is a complication of carotid endarterectomy. The evaluation of the extent of the injury and the persistence of the malfunction is difficult to accomplish with conventional methods. A protocol designed to evaluate motor speech function was administered to 36 patients prior to carotid endarterectomy, 2 days after surgery, and 6 wk postoperatively. The protocol included assessments of hypoglossal nerve function, superior-recurrent laryngeal function, glossopharyngeal nerve function and integrated motor speech ability. Direct laryngoscopy was performed at the same time intervals. The total number of operations was 40. Hypoglossal nerve palsy was present in 8 (20%). Superior-recurrent laryngeal nerve palsy was found in 11 (27.5%). Seven (17.5%) had malfunction of the vocal cords by the 2nd postoperative day. Only 7 (17.5%) of the above cases were detected by the spontaneous speech sample. The malfunction persisted by the 6th postoperative wk in 1 patient (2.5%) with hypoglossal palsy and in 2 (5%) with superior-recurrent laryngeal palsy (1 of them with ipsilateral vocal cord paralysis). Motor speech-related difficulties may be more common following carotid endarterectomy than is generally believed. Although these difficulties are usually temporary in course, they deserve attention, especially in cases of planned bilateral carotid endarterectomy.

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