SYNCHRONOUS MANAGEMENT OF INCIDENTAL NECK MASSES AND CAROTID-ARTERY DISEASE

Incidental identification of neck masses is not uncommon during the wo rkup and management of surgically treatable carotid artery stenosis. R etrospective chart review was made over a 12-month period of all patie nts who underwent carotid endarterectomy. Twelve patients with inciden tal neck masses were identified among 227 subjects. Of these 12 patien ts, three presented with clinically palpable submandibular gland enlar gements, eight had sonographic evidence of incidental thyroid nodules, and one patient had significant enlargement of cervical lymph nodes e xcised at the time of carotid surgery. The last patient was found to h ave a metastatic squamous cell carcinoma originating from the pyriform sinus. Eleven of twelve, patients had successful excisions of the nec k mass synchronous with carotid endarterectomy. The postoperative cour se was uneventful in these 11 patients, but one required postoperative hematoma drainage. All patients were discharged with a length of stay less than 1.5 days. Incidental neck masses are not uncommon. When det ected, these can be managed synchronously with carotid endarterectomy demonstrating no significant change in outcome.