Carotid artery resection for head and neck cancer
| Autor: | Kiyoshi Togawa, Michinori Yokomizo, Zensei Matsuzaki, Akiyoshi Konno, Ryousei Kuribayashi, T Ogawa, Iwao Kanno, Yoshitaka Okamoto, Atsushi Inugami |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Central nervous system disease medicine.artery medicine Humans Stroke Aged Aged 80 and over medicine.diagnostic_test business.industry Head and neck cancer Blood flow Middle Aged medicine.disease Surgery Skull Carotid Arteries medicine.anatomical_structure Cerebral blood flow Head and Neck Neoplasms Positron emission tomography Cerebrovascular Circulation Female Radiology Internal carotid artery business Tomography Emission-Computed |
| Zdroj: | Surgery. 120:54-59 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/s0039-6060(96)80241-8 |
| Popis: | Background. Carotid artery resection has been shown to yield a chance of cure in patients with advanced head and neck carcinoma involving the carotid artery. However, the criteria for the identification of those who are vulnerable to neurologic injury after resection have not been established. Interposition grafting may minimize the risk of neurologic morbidity, although it is technically difficult when there is involvement of the internal carotid artery close to the skull base. Methods. We studied 24 patients with head and neck tumor involvement of the carotid artery. We performed carotid artery resection in 16 of them, including 10 in whom the carotid artery was reconstructed with interposition grafts covered with muscle flaps. When it was thought that the reconstruction would be difficult, positron emission tomography was performed during balloon test occlusion of the internal carotid artery to assess the adequacy of hemispheric collateral blood flow before carotid resection. In one patient with interposition graft, carotid rupture occurred as a result of wound infection, but none of the other patients experienced perioperative death, persistent hemiplegia, or delayed stroke. Result. Twelve patients have survived longer than 8 months, and seven (43.8%) were alive without disease at 12 months after resection, whereas all four patients who could not be treated operatively died within 8 months as a result of local primary tumors. Conclusions. Carotid artery resection is the only therapy offering any potential for cure or palliation. Positron emission tomography is a rapid quantitative means of determining the cerebral blood flow, particularly when resection is planned without reconstruction. |
| Databáze: | OpenAIRE |
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