Design, Setting and Participants
A retrospective analysis was performed on previously treated head and
neck cancer patients who experienced CBS following tumor recurrence
between 2015 and 2020. From medical records of 348 patients, 8 patients
with CBS who had open approach surgical ligation of carotid artery were
detected. Patients treated with endovascular intervention, untreated
cancer patients and patients lost to follow-up were excluded. All of the
patients had head and neck cancer with primary surgery and adjuvant
treatment or salvage surgery and referred to our center with active
bleeding due to CBS who were treated by open surgery with carotid
ligation. CBS was classified as type I (threatened) CBS occurring when
carotid artery was exposed through soft tissue breakdown, type II
(impending) with limited, sentinel bleeding and type III (rupture) with
active bleeding as suggested by Chaloupka et al(1) and Powitzky et
al(12). Demographic data (age, sex), primary site of tumor, neck stage
during primary treatment, type of surgery, radiotherapy history,
predisposing factors (fistula, wound infection, necrosis), site of
rupture, time to recurrence of tumor and time to CBS from exposure of
neck soft tissues were obtained by a review of medical history.
Variables were expressed as percentage, mean ± standard deviation. The
reporting guideline of choice was STROBE (Strengthening the Reporting of
Observational studies in Epidemiology) for this article. (13)