Bilateral lingual artery stenosis: A rare, late complication of chemoradiotherapy

Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Sep;134(4):269-271. doi: 10.1016/j.anorl.2017.02.002. Epub 2017 Mar 11.


Introduction: Carotid artery stenosis following radiotherapy (RT) is a known risk factor for the development of cerebrovascular disease with a risk of subsequent stroke or transient ischaemic attack. In contrast, small vessel disease in the neck following RT has been more rarely described.

Case report: The authors report the case of a 61-year-old man who developed partial lingual necrosis 4 years after surgery and postoperative chemoradiotherapy for squamous cell carcinoma of the floor of the mouth. Contrast-enhanced CT scan confirmed subtotal to total occlusion of both lingual arteries. Surgical debridement of the necrosis allowed complete cure of the lesions.

Discussion: Small vessel disease is a possible complication in patients treated by RT for head and neck cancer. Although the risk of these complications is not directly related to the total radiation dose, higher doses appear to accelerate the development of vascular lesions. Practitioners must be aware of the possibility of these complications, especially in patients surviving more than 5 years.

Keywords: Late complications; Lingual necrosis; Oral cancer; Radiotherapy; Vascular lesion.

Publication types

  • Case Reports

MeSH terms

  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / etiology*
  • Arterial Occlusive Diseases / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy / adverse effects*
  • Constriction, Pathologic
  • Debridement* / methods
  • Head and Neck Neoplasms / therapy
  • Humans
  • Male
  • Middle Aged
  • Necrosis
  • Tomography, X-Ray Computed / methods
  • Tongue / blood supply*
  • Tongue / diagnostic imaging
  • Tongue / surgery*
  • Treatment Outcome