Carotid artery sacrifice testing: assessment in patients with advanced head and neck cancer.
The otolaryngologist seeking a cure of the patient with advanced cancer of the head and neck removes all neck metastases along with the primary tumor. Tumor involvement of the carotid artery presents a special dilemma to the otolaryngologist because a complete resection would mean removal of the affected carotid artery, a procedure which has, historically, carried high morbidity and mortality rates. Today, the otolaryngologist will offer tumor resection with carotid artery sacrifice only after a patient passes a preoperative assessment of collateral circulation to the brain. Numerous methods have been devised to determine a patient's preoperative risk of neurologic compromise. Several tests are detailed and their usefulness discussed.
Lejeune
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HB
Tulane University Medical School, Dept of Otolaryngology-Head and Neck Surgery, New Orleans.
Cote
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DN
D017536:Carotid Artery, Common / Q000502:physiology* / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000502:physiology* / Q000601:surgery*; D002404:Catheterization; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003097:Collateral Circulation / Q000502:physiology*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial; D014978:Xenon
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D014978:Xenon