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Skull Base 2009; 19(5): 369-373
DOI: 10.1055/s-0029-1220204
CASE REPORT

© Thieme Medical Publishers

Glossopharyngeal and Limited Vagal Neurectomy for Cancer-Related Carotid Sinus Syncope

Harrison W. Lin1 , 2 , Michael B. Rho1 , 2 , Sepideh Amin-Hanjani4 , Fred G. Barker3 , Daniel G. Deschler1 , 2
  • 1Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • 2Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts
  • 3Department of Neurosurgical Service, Massachusetts General Hospital, Boston, Massachusetts
  • 4Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois
Further Information

Publication History

Publication Date:
03 April 2009 (online)

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ABSTRACT

Head and neck cancer patients with cervical disease involving the glossopharyngeal or vagus nerves can experience dangerous cardiovascular phenomena, including carotid sinus syncope (CSS). Medical and minimally invasive interventions, including pacemaker placement, incompletely address the etiologies of syncopal episodes and therefore often provide limited benefit. The objectives of this report are to highlight the difficulties of managing cancer-related CSS, to present a highly effective surgical intervention, and to review the literature regarding the pathophysiology and treatment options for patients with cancer-related CSS. Two patients with cancer-related CSS continued to experience syncopal episodes despite medical and pacemaker therapy. Consequently, these patients underwent a suboccipital craniotomy for glossopharyngeal and limited vagal neurectomy. After surgery, both patients had uncomplicated postoperative courses with resolution of syncope.

KEYWORDS

Head and neck cancer - carotid sinus - syncope - glossopharyngeal neuralgia - neurectomy

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Daniel G DeschlerM.D. F.A.C.S. 

Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary

243 Charles Street, Boston, MA 02114

Email: Daniel_Deschler@meei.harvard.edu

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