Resection and reconstruction of carotid artery involved in advanced head and neck carcinoma: Report of 3 cases

Advanced head and neck carcinoma (HNC) that invaded carotid artery (CA) has a poor prognosis. CA resection en-bloc with the tumor is the only procedure that could provide a cure. However, resection of CA may cause neurological complications and the approach to infiltrated CA remains controversial. We have experienced three cases of advanced HNC with CA infiltration where preoperative evaluations of the possibility of CA ligation were conducted. One developed neurological sequelae after ligation and died of local recurrence although preoperative evaluation demonstrated that CA ligation was possible. Two underwent reconstruction where one is still alive 8-years postoperatively and one died of distant metastasis. We concluded that resection and active reconstruction of CA should be performed to reduce neurological complications and to acquire better quality of life (QOL).