Preoperative permanent balloon occlusion of internal carotid artery in patients with advanced head and neck squamous cell carcinoma

Objective/Hypothesis: To determine the value of preoperative balloon occlus ion in predicting the safety of carotid artery resection in advanced recurr ent head and neck squamous cell carcinoma. Study Design: Retrospective char t review of all cases undergoing planned carotid artery resection for recur rent disease at a major university hospital. Methods: If the carotid artery was encased, a nonemergent carotid artery balloon test occlusion was perfo rmed for 30 minutes. If the patient tolerated this, he or she underwent per manent carotid artery occlusion, Results: Twenty-three patients were prospe ctively evaluated for resection, Three underwent emergent carotid artery li gation, Twenty others underwent nonemergent carotid artery test occlusion, Of these, 5 patients failed preoperative carotid artery balloon occlusion a nd 15 patients successfully underwent permanent carotid balloon occlusion, Although eight of these patients died of recurrent disease in less than 1 y ear, seven patients survived more than 1 year with two patients surviving m ore than 2 years. Conclusions: Preoperative carotid balloon occlusion predi cted patients who could tolerate permanent occlusion, All patients eventual ly developed recurrent disease, but in 14 of the 15 patients, no hemorrhage s occurred.