Sacrificing the internal carotid artery in infiltrating neck tumours: a study of four clinical cases

Tumour infiltration of the carotid arteries, especially the common carotid artery (CCA) and the internal carotid artery (ICA), is a great challenge in maxillofacial surgery. Cases in which the malignant tumour and/or lymph node is stuck to the carotid artery, especially the ICA, have previously been considered inoperable. Four such cases, two with recurrent metastatic nodal neck masses encasing the ICA, one with aggressive fibromatosis, and one with a carotid body tumour, are described herein. Successful resection of the mass along with the ICA was performed in all cases after a positive balloon occlusion test. All patients made an uneventful recovery with no signs or symptoms of any neurological deficits. In addition, all of the patients were free of disease for the whole postoperative period of 18 months.