頸部悪性腫瘍による左頸動脈洞反射亢進症について

Carotid Sinus Hypersensitivity Caused by Head and Neck Tumor

　はじめに

　頸部悪性腫瘍に伴う頸動脈洞反射亢進症は，徐脈，低血圧，失神を誘発することが知られている^1）。今回われわれは，頸部悪性腫瘍に伴う左側頸動脈洞反射亢進症により，房室ブロックをきたした2症例を報告するとともに，頸部悪性腫瘍に伴う左および右頸動脈洞反射亢進症の病態生理，治療法について文献的考察を行った。

Carotid sinus hypersensitivity secondary to the presence of head and neck tumor was manifested as bradycardia, hypotension and syncope. We experi-enced two cases with A-V block induced by left carotid sinus hypersensitivity.

Case 1 : a 55-year-old man presented with squamous cell carcinoma in the left mesopharyngealarea.

Tumor was found around the carotid artery and vagus nerve. Radical neck dissection on the left side was performed after radiation therapy but tumor was not totally removed. His syncopal attack was occurred frequently after 15 th postoperative day and ECG revealed A-V block. Syncopal attack spontaneously resolved after the 24 th postoperative day.

Case 2 : a 70-year-old man presented with squamous cell carcinoma in metastatic lymph nodes in the neck. He developed severe headache and syncopal attack after radiation therapy. ECG revealed A-V block. Syncopal attack continued for about 9 months.