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Article
September 1995

Internal Carotid Artery Resection for Invasion of Malignant Tumors

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery, University of California—Davis, Sacramento.

Arch Otolaryngol Head Neck Surg. 1995;121(9):1029-1033. doi:10.1001/archotol.1995.01890090067013
Abstract

Background:  To study the preoperative investigation and outcome of patients who underwent resection of the internal carotid artery for malignant disease. A retrospective analysis using a chart review of these patients was performed, and the results were analyzed. All patients were treated by one of us (U.K.N.) at the University of California—Davis Medical Center, Sacramento. A population of 18 patients who underwent a transcervical, transpetrosal, or petrocavernous resection of the internal carotid artery from 1976 to 1993 was studied. Preoperative study consisted of four-vessel arteriography, balloon test occlusion, electroencephalographic intraoperative monitoring, and, after 1990, single-photon emission computed tomographic scanning. Disease-free interval and neurologic complications were assessed.

Results:  Two patients were alive and well without disease at 6 and 9 months postoperatively. One patient was alive and well at 12 months, and three have survived more than 2 years without recurrent tumor. Eleven patients died within 1 year of surgery (three postoperatively, six of recurrent disease, and two of unknown causes). One patient died of disease at 14 months.

Conclusions:  Internal carotid artery invasion by malignancy portends a poor prognosis. Carotid artery resection can provide reasonable palliation. Early results of skull-base surgery on patients with intrapetrous and petrocavernous carotid artery involvement are encouraging. Balloon test occlusion and single-photon emission computed tomographic scanning provide a valuable assessment of contralateral cerebral blood flow.(Arch Otolaryngol Head Neck Surg. 1995;121:1029-1033)

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