Urgent carotid artery ligation in advancedhead and neck cancer bleeding

Abstract:

Objective: Although bleeding due to head and neck cancer infiltration is a rare complication, it may be life threatening and requires urgent intervention. The aim of this study was to investigate the efficiency of carotid artery ligation applications on bleeding patients with advanced head and neck cancer.

Methods: Urgent carotid artery ligation performed in the last 8 years for abundant bleeding in 12 patients with advanced stage head and neck cancer were analyzed retrospectively. The patients were evaluated in terms of demographic characteristics, diagnoses, treatment approaches, neurological complications and mortality.

Results: Mean age of 12 patients included in the study was 49.7±9.4 (range 37-69), two of them were females (16.7%) and 10 were males (83.3%). Ten patients were diagnosed as carcinoma of larynx or hypopharynx, whereas one patient had nasal malign melanoma and one patient had buccal carsinoma. Abundant bleeding was observed in patients with recurrent disease after surgery and radiotherapy (n=7), applied radiotherapy or chemoradiotherapy as considered inoperable (n=2), received no treatment (n=2) and patient with recurrence after surgery (n=1). Common carotid artery ligation was performed in 10 patients and external carotid artery ligation was performed in two patients and hemostasis was achieved in all of them. No neurological complications or postoperative mortality were observed in any patients after ligation.

Conclusion: In our study, it was observed that application of urgent carotid artery ligation was successful in patients with bleeding due to advanced head and neck surgery. Therefore, it was concluded that carotid artery ligation was a safe and effective method for bleeding due to tumor infiltration.