Evaluation of syncope from head and neck cancer

Papay, Francis; Roberts, Jay K.; Wegryn, Tara; Gordon, T. A.; Levine, Howard L.

doi:10.1288/00005537-198904000-00004

Cited by 44 publications

(16 citation statements)

References 14 publications

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“…Carotid sinus compression by a neck mass or the invasion of the tumor in patients with head and neck cancer can cause episodes of bradycardia and intermittent pauses. Carotid body tumors, local tumors such as thyroid cancers, cervical lymphadenopathy, postradiation fibrosis, and internal carotid artery aneurysms, are known to cause carotid sinus sensitivity [ 5 – 7 ]. Although the pathophysiology of this process is well-characterized, it is suggested to be associated with a permanent depolarization of neuronal axons with an increased sensitivity to impulses.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

Deshmukh

Özcan

2017

Case Reports in Cardiology

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Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes.

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Section: Discussionmentioning

confidence: 99%

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

Deshmukh

Özcan

2017

Case Reports in Cardiology

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“…Muntz and Smith in 1983 postulated that a tumor located near the Carotid Sinus or it’s nerve could cause a permanent depolarization of its axons with an increased tendency of adjacent uninjured axons to fire impulses causing signs and symptoms of CSS [ 19 ]. Radiation therapy of the carotid sinus has often been used to treat malignancies of the head and neck region, but some case series have described it as a cause of CSH (by post-irradiation fibrosis) by a mechanism similar to the one just described [ 20 ]. Wallin and Westerberg suggested that syncope in these patients is caused by abnormal impulses that are rerouted via the pharynx to the dorsal motor nucleus of vagus, causing excitation of the vagus [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

A case of asystole from carotid sinus hypersensitivity during patient positioning for thyroidectomy

et al. 2015

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BackgroundWe present a case of a patient with multinodular goiter disease who suffered asystole during head hyperextension for surgical positioning on the operational table.Case PresentationManipulation of carotid sinus may trigger bradycardia or even asystole even in patients without prior history of carotid sinus hypersensitivity. The time proximity between patient positioning and asystole, the late responsiveness to atropine, the immediate increase of heart rate after head elevation and the lack of any other trigger factor or prior history support the hypothesis of carotid sinus syndrome.ConclusionsHead hyperextension during surgical positioning is not only responsible for jeopardizing blood flow to spinal cord and brainstem but may trigger reflexes, as well, even in patients without prior neck pathology.

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“…The majority of reports of carotid sinus syndrome associated with head and neck malignancy relate to extensive nodal involvement in the neck [14]. …”

Section: Discussionmentioning

confidence: 99%

Carotid sinus syndrome as the presenting symptom of cystadenolymphoma

et al. 2012

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Carotid sinus syndrome is a serious manifestation of head and neck malignancy. The purpose of this study was to clarify the presence of carotid sinus syndrome in a patient with cystadenolymphoma. To our knowledge carotid sinus syndrome secondary to cystadenolymphoma has not been reported to date. A 45-year-old woman with one-week-old swelling in the left mandibular angle having disturbing symptoms of vertigo, consciousness and sinus arrest. Holter monitoring revealed several episodes of sinus arrest. Ultrasonography showed a well-defined space-occupying lesion of about 31 mm in length and 17 mm in width located in the deep lobe of the left parotid gland. Computerized tomography (CT) showed a large mass extending into the carotid space and protruding into the parapharyngeal space. Parotidectomy was performed. Surgical removal of the tumor resulted in complete amelioration of symptoms and disappearance of electrocardiogram abnormalities. Here we report on a clinical case of carotid sinus syndrome associated with cystadenolymphoma. To our knowledge carotid sinus syndrome secondary to cystadenolymphoma has not been reported to date, and is made more remarkable as a possible differential diagnosis after clarification of all possible causes. Early diagnosis and immediate management can minimize complications.

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Evaluation of syncope from head and neck cancer

Cited by 44 publications

References 14 publications

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

A case of asystole from carotid sinus hypersensitivity during patient positioning for thyroidectomy

Carotid sinus syndrome as the presenting symptom of cystadenolymphoma

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