A Treatment Approach for Carotid Blowout Syndrome and Soft Tissue Reconstruction after Radiotherapy in Patients with Oral Cancer: A Report of 2 Cases

Möst T, Kesting MR, Rohde M, Lang W, Meyer A, Weber M, Lutz R (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Journal of Clinical Medicine MDPI

Book Volume: 12

Article Number: 3221

Journal Issue: 9

DOI: 10.3390/jcm12093221

Abstract

Background: This retrospective case series study aims to demonstrate a salvage technique for the treatment of carotid blow-out syndrome (CBS) in irradiated head and neck cancer patients with a vessel-depleted neck. Methods: Between October 2017 and October 2021, two patients (N = 2) with CBS were treated at our institution in a multidisciplinary approach together with the Department of Vascular Surgery. Patients were characterized based on diagnoses, treatment procedures, and the subsequent postoperative course. Results: Surgical emergency intervention was performed in both cases. The transition zone from the common carotid artery (CCA) to the internal carotid artery (ICA) was resected and reconstructed with a xenogic (case 1) or autogenic (case 2) interposition (end-to-end anastomosis). To allow reconstruction of the vascular defect, an additional autologous vein graft was anastomosed to the interposition graft in an end-to-side technique, allowing arterial anastomosis for a free microvascular flap without re-clamping of the ICA. Because of the intraoperative ICA reconstruction, none of the patients suffered a neurological deficit. Conclusions: The techniques presented in the form of two case reports allow for acute bleeding control, cerebral perfusion, and the creation of a vascular anastomosis option in the vessel-depleted neck.

Authors with CRIS profile

Tobias Möst Department of Oral and Cranio-Maxillofacial Surgery Marco Rainer Kesting Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie Maximilian Rohde Department of Oral and Cranio-Maxillofacial Surgery Werner Lang Department of Vascular Surgery Manuel Weber Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie

How to cite

APA:

Möst, T., Kesting, M.R., Rohde, M., Lang, W., Meyer, A., Weber, M., & Lutz, R. (2023). A Treatment Approach for Carotid Blowout Syndrome and Soft Tissue Reconstruction after Radiotherapy in Patients with Oral Cancer: A Report of 2 Cases. Journal of Clinical Medicine, 12(9). https://doi.org/10.3390/jcm12093221

MLA:

Möst, Tobias, et al. "A Treatment Approach for Carotid Blowout Syndrome and Soft Tissue Reconstruction after Radiotherapy in Patients with Oral Cancer: A Report of 2 Cases." Journal of Clinical Medicine 12.9 (2023).

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