Carotid artery injury after endonasal surgery

Otolaryngol Clin North Am. 2011 Oct;44(5):1059-79. doi: 10.1016/j.otc.2011.06.009. Epub 2011 Jul 21.


Carotid artery injury during endonasal surgery is the most feared and catastrophic complication. Internal carotid artery injury is more frequent during skull base surgery, and risk factors include acromegaly, previous revision surgery, and prior radiotherapy and bromocriptine therapy. Nasal packing is frequently used to gain hemostasis, often resulting in vascular occlusion. Recent research recommends the crushed muscle patch treatment as an effect hemostat that maintains vascular patency. Endovascular techniques are recommended for vascular control and complication management. Coil or balloon embolization is preferred in patients with adequate collateral cerebral blood flow, and stent-graft placement or bypass surgery is indicated in those who do not.

Publication types

  • Review

MeSH terms

  • Aneurysm / complications
  • Aneurysm, Ruptured / etiology
  • Aneurysm, Ruptured / therapy
  • Carotid Artery Injuries / etiology*
  • Carotid Artery, Internal*
  • Endoscopy / adverse effects*
  • Hemostasis, Surgical
  • Humans
  • Intraoperative Complications
  • Neurosurgical Procedures / adverse effects
  • Paranasal Sinuses / surgery*
  • Risk Factors
  • Skull Base / surgery*