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Multiple Cranial Neuropathies and First Bite Syndrome after Carotid Endarterectomy
Author(s) -
Harirchian Sanaz,
Benson Brian
Publication year - 2011
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21944
Subject(s) - citation , dept , library science , carotid endarterectomy , medicine , center (category theory) , psychology , surgery , computer science , carotid arteries , chemistry , crystallography , immunology
Postoperatively, the patient reported persistent severe (10/10) left sided facial pain during the first few bites of meals. The patient also reported hoarseness, left lower lip weakness, and postprandial left-sided otalgia. Left marginal mandibular weakness was noted on physical examination. Videostroboscopy revealed a left vocal fold paresis (Figure 1) with severe glottic incompetence, and hypersensitivity of the left hemilarynx. Laryngeal EMG revealed an absence of fibrillations or fasciculations and giant wave activity was noted. A MRI of the neck with contrast revealed only postoperative changes. Injection laryngoplasty with calcium hydroxylapetite and speech therapy resulted in near complete resolution of his glottic incompetence (Figure 2). The facial nerve weakness resolved spontaneously.