Preoperative permanent balloon occlusion of internal carotid artery in patients with advanced head and neck squamous cell carcinoma

Laryngoscope. 1999 Mar;109(3):460-6. doi: 10.1097/00005537-199903000-00022.


Objective/hypothesis: To determine the value of preoperative balloon occlusion in predicting the safety of carotid artery resection in advanced recurrent head and neck squamous cell carcinoma.

Study design: Retrospective chart review of all cases undergoing planned carotid artery resection for recurrent disease at a major university hospital.

Methods: If the carotid artery was encased, a nonemergent carotid artery balloon test occlusion was performed for 30 minutes. If the patient tolerated this, he or she underwent permanent carotid artery occlusion.

Results: Twenty-three patients were prospectively evaluated for resection. Three underwent emergent carotid artery ligation. Twenty others underwent nonemergent carotid artery test occlusion. Of these, 5 patients failed preoperative carotid artery balloon occlusion and 15 patients successfully underwent permanent carotid balloon occlusion. Although eight of these patients died of recurrent disease in less than 1 year, seven patients survived more than 1 year with two patients surviving more than 2 years.

Conclusions: Preoperative carotid balloon occlusion predicted patients who could tolerate permanent occlusion. All patients eventually developed recurrent disease, but in 14 of the 15 patients, no hemorrhages occurred.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / blood supply
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery*
  • Carotid Artery, Internal* / surgery
  • Diagnostic Imaging
  • Embolization, Therapeutic / instrumentation*
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local / blood supply
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Otorhinolaryngologic Neoplasms / blood supply
  • Otorhinolaryngologic Neoplasms / mortality
  • Otorhinolaryngologic Neoplasms / surgery*
  • Preoperative Care*
  • Prospective Studies
  • Reoperation
  • Retrospective Studies
  • Survival Rate