Vol.101 No.9 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 9 September 2008
Cardiac Pacemaker Implantation for a Patient with Terminal Laryngeal Cancer Associated with Carotid Sinus Syndrome
Nobusuke Hohchi and Hideaki Suzuki
(University of Occupational and Environmental Health)
Shinya Tachibana, Naohiko Watanabe, Hiroyuki Zusho and Tomoko Sugiuchi
(Kanto Rosai Hospital)
Taketoshi Nogaki and Yoshihiro Yamada
(Showa University Northern Yokohama Hospital)
A 62-year-old man with terminal laryngeal cancer developed repetitive syncope attacks each time he moved his neck. He was thereby forced to endure strict bed rest, severely limiting his activities of daily living. From clinical manifestations, radiographic findings, and cardiovascular examinations, he was diagnosed as having carotid sinus syndrome caused by tumor invasion to the carotid bifurcation. He was administered anti-cholinergic and steroid drugs, but those were ineffective. Because the patient and his family wished to continue home care, he then underwent cardiac pacemaker implantation. The syncope attack completely disappeared thereafter, and his activities of daily living and thus quality of life dramatically improved. He survived for 239 days after implantation with a total home care period of 191 days. We conclude that advanced medical technology including pacemaker treatment can provide a significant and effective means to relieve patients even with terminal cancer.
Key words :cardiac pacemaker, terminal stage, laryngeal cancer, carotid sinus syndrome