Key Points
  1. Carotid blow-out syndrome (CBS) is one of the uncommon yet detrimental complications in head and neck cancer patients, by presenting itself as a catastrophic bleeding.
  2. There are various risk factors for CBS such as prior radiotherapy, prior radical neck dissection, mucocutaneous fistula, flap necrosis, wound infection, poor nutrition and tumor recurrence.
  3. Prevention may be the most effective treatment by using various reconstructive procedures such as myocutaneous flaps to hinder the exposure of carotid artery and to avoid pharyngocutaneous fistula.
  4. Regardless of the treatment choice; angiography is accepted as gold standard for diagnosis, by also having the advantage of evaluating the patency of contralateral carotid system with balloon occlusion test, thus leading the treatment option.
  5. Since, it has a high mortality and neurologic morbidity, preventing CBS would be the most effective treatment method, because the countdown is approximately set to 4 months.