Carotid artery resection for head and neck cancer

Occasionally, the head and neck surgeon encounters a patient whose malignancy involves the carotid artery. In these patients, curative or palliative surgery may require excision of the common or the internal carotid artery. However, the high complication and death rates dissuade many surgeons from undertaking carotid artery resection. This study reviews the outcomes in 20 patients treated between 1979 and 1985 at the Department of Otolaryngology-Head and Neck Surgery, The University of Iowa Hospitals and Clinics, with resection of the carotid artery for head and neck cancer. The carotid artery was electively resected in 16 patients, while 4 patients underwent emergent carotid artery ligation. In the group of patients studied the stroke rate was 25%, the death rate 20%, and the combined stroke and death rate 30%. Of the patients who survived the procedure, all but 1 died of complications caused by tumor recurrence. These results are discussed, and compared with results from other studies.