進行上咽頭癌による頸動脈洞症候群の1例

A case report of carotid sinus syndrome caused by advanced nasopharyngeal cancer

Ⅰ．はじめに

　頸動脈洞症候群は，頸動脈洞反射の異常亢進により失神発作を生じる疾患である。頸動脈洞症候群の原因はさまざまであるが，頭頸部癌においては腫瘍もしくはリンパ節転移により頸動脈洞が刺激され，頸動脈洞反射を生じうる。原疾患の根治が難しい場合には，繰り返す失神発作によって患者のQOLは著しく低下する。今回われわれは，進行上咽頭癌による頸動脈洞症候群に対して恒久ペースメーカー植え込み術を施行し，症状の改善が得られた症例を経験したので，若干の文献的考察を加えて報告する。

　Carotid sinus syndrome is due to overreaction of carotid sinus baroreceptor reflex. We report a patient with carotid sinus syndrome caused by advanced nasopharyngeal cancer who was effectively treated with cardiac pacemaker. Tumor invasion to carotid bifurcation caused syncopal attack on the occasion of body movement. In this case,neither livelihood guidance nor medication were not effective. We performed cardiac pacemaker implantation,and syncopal attack disappeared. He could underwent full dose radiation therapy. His quality of life was remarkably improved. We considered that cardiac pacemaker implantation could be one of the management for carotid sinus syndrome caused by advanced head and neck cancer.