Head and neck cancer patients with cervical disease involving the glossopharyngeal or vagus nerves can experience dangerous cardiovascular phenomena, including
carotid sinus syncope (CSS). Medical and minimally invasive interventions, including pacemaker placement, incompletely address the etiologies of
syncopal episodes and therefore often provide limited benefit. The objectives of this report are to highlight the difficulties of managing
cancer-related CSS, to present a highly effective surgical intervention, and to review the literature regarding the pathophysiology and treatment options for patients with
cancer-related CSS. Two patients with
cancer-related CSS continued to experience
syncopal episodes despite medical and pacemaker
therapy. Consequently, these patients underwent a suboccipital
craniotomy for glossopharyngeal and limited vagal
neurectomy. After surgery, both patients had uncomplicated postoperative courses with resolution of
syncope.