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Delayed carotid blow-out syndrome: a new complication of chemoradiotherapy treatment in pharyngolaryngeal carcinoma
E Esteller, X León, M de Juan, M Quer
Journal:

The Journal of Laryngology & Otology / Volume 126 / Issue 11 / November 2012

Published online by Cambridge University Press:

11 September 2012, pp. 1189-1191

Print publication:

November 2012
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Background:
Carotid blow-out syndrome is one of the most devastating complications of head and neck carcinoma. It usually occurs as a post-operative complication or when the tumour compromises the vascular axis.
Methods and results:
We report two patients who suffered carotid blow-out syndrome but who did not have the usual predisposing factors. Both patients had a pharyngolaryngeal carcinoma that was treated with chemoradiotherapy. Residual non-tumoural ulceration was seen along the lateral wall of the hypopharynx in both cases. This ulceration eventually reached the vascular axis, precipitating carotid rupture and death.
Conclusion:
Residual non-tumoural ulceration of the lateral wall of the hypopharynx after chemoradiotherapy should be considered with the utmost caution. Once persistence of the tumour is excluded, surgery is indicated to protect the vascular axis, in order to prevent carotid blow-out syndrome.

Extracranial internal carotid artery aneurysm presenting as symptomatic hypoglossal and glossopharyngeal nerve paralysis
L. J. Wilding, D. C. Howlett, H. J. Anderson, P. D. Sangle, N. Violaris, G. H. Evans
Journal:

The Journal of Laryngology & Otology / Volume 118 / Issue 2 / February 2004

Published online by Cambridge University Press:

08 March 2006, pp. 150-152

Print publication:

February 2004
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Aneurysms of the extracranial portion of the internal carotid artery are rare, particularly in young patients. They usually develop following trauma, or secondary to infection involving the parapharyngeal space that extends to the vessel wall. This is a case of an internal carotid artery aneurysm presenting acutely following chiropractic neck manipulation with hypoglossal and glossopharyngeal nerve palsy. The imaging findings and subsequent operative management are described.

The case of the missing carotid artery – a well aimed knife!
Hesham M. Mehanna, Fiona B. MacGregor
Journal:

The Journal of Laryngology & Otology / Volume 112 / Issue 4 / April 1998

Published online by Cambridge University Press:

29 June 2007, pp. 387-388

Print publication:

April 1998
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A 20-year-old male presented with a small stab wound to the neck and with haemodynamic signs of significant haemorrhage, but no signs of local bleeding. On exploration, an intact vagus nerve and internal jugular vein were found, but the common carotid artery was not immediately apparent. Careful dissection confirmed a completely transected common carotid artery with the two ends contracted and retracted. A primary repair was performed and post-operatively the patient recovered completely and had no neurological deficit.