A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy

İlker Kiriş; Şenol Gülmen; Emre Doğan; Hüseyin Okutan

KAROTİS ENDARTEREKTOMİ SIRASINDA ‘Y’ ŞEKLİNDE PATCHPLASTİ YAPILAN VE ATİPİK YERLEŞİMLİ HİPOGLOSSUS SİNİRİNE CERRAHİ TRAVMANIN ÖNLENDİĞİ BİR OLGU

Year 2009, Issue: 1, 31 - 34, 01.04.2009

İlker Kiriş Şenol Gülmen Emre Doğan Hüseyin Okutan

Abstract

Beş yıl önce sol karotis endarterektomi operasyonu yapılmış olan altmış yedi yaşında erkek hasta başdönmesi yakınması ile kliniğimize başvurdu. Doppler ultrasonografi ve intraarteriyel digital substractedanjiyografi sağ internal karotis arterde %90 darlığı açığa çıkardı. Sağ karotis endarterektomioperasyonu sırasında common, eksternal ve internal karotis artere ulaşıldığında, nervushipoglossusun beklenen anatomik lokalizasyonundan daha aşağıda olduğu ve bulbus karotisiçaprazladığı görüldü. Atipik yerleşimli nervus hipoglossus korunarak common karotis arterdearteriyotomi yapıldı. Arteriyotomi distale doğru ilerletildiğinde yoğun aterosklerotik plağın hem internalhem de eksternal karotis artere uzandığı tespit edildi. Common karotis arterden başlatılan arteriyotomive endarterektomi planı hem eksternal hem de internal karotis artere uzatıldı. Y şeklindeki ince duvarlıbir polytetrafluoroethylene yama hazırlandı. Yamanın proksimal ucu common karotis artere, distaldekiuçları da eksternal ve internal karotis arterlere dikilerek patch plasti tamamlandı. Hasta onuncu ayındasorunsuz izlenmektedir.

Keywords

Karotis endarterektomi, nervus hipoglossus.

A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy

Year 2009, Issue: 1, 31 - 34, 01.04.2009

İlker Kiriş Şenol Gülmen Emre Doğan Hüseyin Okutan

Abstract

A 67-year-old man who underwent left carotid endarterectomy five years ago admitted to our clinicwith complaint of dizziness. Doppler ultrasonography and intraarterial digital substracted angiographyrevealed 90 % stenosis in the right internal carotid artery. During right carotid endarterectomyoperation, following exposure of common, external and internal carotid arteries, nervus hypoglossuswas found to be placed lower than its expected anatomic localisation, crossing the carotid bulb. Anarteriotomy in the common carotid artery was done by preserving atypically placed nervushypoglossus. When arteriotomy was extended distally, a heavy aterosclerotic plaque was found toextend to both external and internal carotid arteries. The arteriotomy and endarterectomy planes thatwere started in common carotid arteries were extended to both external and internal carotid arteries. AY-shaped, thin wall polytetrafluoroethylene patch was prepared. Proximal end of the patch wassutured to common carotid artery and the patchplasty was completed by suturing the distal ends of thepatch to external and internal carotid arteries. The patient remains in good health in his postoperativetenth month.

Keywords

Carotid endarterectomy, hypoglossal

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Details

Other ID	JA63AJ37ET
Journal Section	Research Article
Authors	İlker Kiriş This is me Şenol Gülmen This is me Emre Doğan This is me Hüseyin Okutan This is me
Publication Date	April 1, 2009
Submission Date	April 1, 2009
Published in Issue	Year 2009 Issue: 1

Cite

APA	Kiriş, İ., Gülmen, Ş., Doğan, E., Okutan, H. (2009). A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy. Pamukkale Medical Journal(1), 31-34.
AMA	Kiriş İ, Gülmen Ş, Doğan E, Okutan H. A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy. Pam Med J. April 2009;(1):31-34.
Chicago	Kiriş, İlker, Şenol Gülmen, Emre Doğan, and Hüseyin Okutan. “A Case in Whom Y-Shaped Patchplasty Was Done and Surgical Trauma to Atypically Placed Nervus Hypoglossus Was Avoided During Carotid Endarterectomy”. Pamukkale Medical Journal, no. 1 (April 2009): 31-34.
EndNote	Kiriş İ, Gülmen Ş, Doğan E, Okutan H (April 1, 2009) A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy. Pamukkale Medical Journal 1 31–34.
IEEE	İ. Kiriş, Ş. Gülmen, E. Doğan, and H. Okutan, “A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy”, Pam Med J, no. 1, pp. 31–34, April 2009.
ISNAD	Kiriş, İlker et al. “A Case in Whom Y-Shaped Patchplasty Was Done and Surgical Trauma to Atypically Placed Nervus Hypoglossus Was Avoided During Carotid Endarterectomy”. Pamukkale Medical Journal 1 (April 2009), 31-34.
JAMA	Kiriş İ, Gülmen Ş, Doğan E, Okutan H. A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy. Pam Med J. 2009;:31–34.
MLA	Kiriş, İlker et al. “A Case in Whom Y-Shaped Patchplasty Was Done and Surgical Trauma to Atypically Placed Nervus Hypoglossus Was Avoided During Carotid Endarterectomy”. Pamukkale Medical Journal, no. 1, 2009, pp. 31-34.
Vancouver	Kiriş İ, Gülmen Ş, Doğan E, Okutan H. A case in whom y-shaped patchplasty was done and surgical trauma to Atypically placed nervus hypoglossus was avoided during carotid Endarterectomy. Pam Med J. 2009(1):31-4.