The Dilemma of Treating Head and Neck Cancer Recurrence Associated Repeated Carotid Sinus Syncopes-A Case Report

治療頭頸癌復發合併之反覆頸動脈竇昏厥的困境－病例報告

周厚江(Hou-Chiang Chou) ； 林秉毅(Pin-Yi Lin) ； 胡廣煜(Kwuang-Yu Hu) ； 江俊斌(Chun-Pin Chiang) ； 郭英雄(Ying-Shiung Kuo)

《臺灣口腔顎面外科學會雜誌》 29卷3期 (2018/09) Pp. 209-217

摘要

Carotid sinus syncope is a rarely encountered syndrome in patients with head and neck cancer. The mechanism of carotid sinus syncope is considered mainly due to the compression of the carotid sinus or invasion of the glossopharyngeal nerve by a space-occupying lesion. When the excitation of carotid sinus reflex is activated, it can manifest as hypotension, bradycardia, dizziness, and syncope. Because carotid sinus syncope is infrequently associated with head and neck malignancy, it is difficult to be recognized and diagnosed. Moreover, the treatment is also challenging. We presented a case of a 54-year-old male with a right buccal squamous cell carcinoma. He suffered from repeated carotid sinus syncope 6 months after the cancer excision. Cancer recurrence was subsequently confirmed. The purpose of this case report was to illustrate the dilemma we encountered. Moreover, we also discussed the feasible treatments of carotid sinus syncope in patients with head and neck cancer.

關鍵字

Carotid sinus syncope ； Head and neck cancer ； Recurrence ； Glossopharyngeal nerve

並列摘要

頸動脈竇昏厥在頭頸癌的患者中是一種罕見的併發症，其病因一般被認為是由於頸動頸竇被一佔據空間的病灶壓迫、或是舌咽神經被病灶所侵犯而造成。當頸動脈竇反射興奮被啟動，可以引發低血壓、心搏過緩、暈眩以及昏厥。由於和頭頸癌相關的頸動脈竇昏厥並不常見，它很難發現，也難以診斷。此外，其治療也是一大挑戰。我們報告一位54歲男性在右頰有鱗狀細胞癌，在手術後6個月罹患了反覆的頸動脈竇昏厥，癌症復發也隨之被證實。我們藉此報告以說明我們在面對頭頸癌患者合併有頸動脈竇昏厥時所遇到的困境，以及討論其可行的治療。

並列關鍵字

頸動脈竇昏厥 ； 頭頸癌復發 ； 舌咽神經