Radical neck dissection after prosthetic repair of carotid artery

A carcinoma of the pyriform fossa developed ten years after a Teflon patch graft angioplasty of the common and internal carotid vessels. The graft was embedded in fibrous tissue and covered by pseudoadventitia, which could be dissected free without difficulty. If radiation therapy is used, it should be administered postoperatively. The Teflon graft can be protected from possible salivary fistulae by a dermal graft that is covered by a levator scapulae muscle flap, which is sutured to the prevertebral fascia to separate the carotid vessels from the pharynx, but it is not recommended that the tumor resection be staged to achieve this carotid protection.