Key Points
- 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.
- 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.
- 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.
- 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.
- 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.