Management of Carotid Blowout from Radiation Necrosis.
Although the incidence of carotid blowout has decreased with the advent of better reconstructive techniques, it remains a real risk after major head and neck surgery, especially in an irradiated field. A systematic, multidisciplinary approach incorporating appropriate history and physical examination, adequate resuscitation, diagnostic computed tomography, and diagnostic and therapeutic angiography can manage most of these patients in a safe and effective manner. Surgery has a limited role in acute management, although surgical techniques are useful both for prevention of this problem and for wound management after carotid blowout.
Department of Otolaryngology/Head and Neck Surgery, Portland VA Medical Center, Oregon Health Sciences University, Portland, OR, USA.
John
J
Gleysteen
Department of Otolaryngology/Head and Neck Surgery, Portland VA Medical Center, Oregon Health Sciences University, Portland, OR, USA.
Daniel
D
Clayburgh
ENT, Department of Otolaryngology/Head and Neck Surgery, Portland VA Medical Center, Oregon Health Sciences University, P3-OC, 3710 Southwest US Veteran's Hospital Road, Portland, OR 97239, USA. Electronic address: James.Cohen2@va.gov.
James
J
Cohen
D020212:Carotid Artery Injuries / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D019468:Disease Management; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D012422:Rupture, Spontaneous; D014656:Vascular Surgical Procedures / Q000379:methods*
Carotid blowout; Endovascular; Radiation complication