Is carotid reconstruction for advanced cancer in the neck a safe procedure?

Head and neck surgeons hesitate to resect the carotid artery because of the postoperative risk of neurologic sequelae, On the other hand, there is no curative therapeutic option for head and neck cancer involving the carotid artery, except for complete tumor removal. A retrospective review of all pu blished articles in the English literature dealing with carotid reconstruct ion for head and neck cancer from 1987 to 1998 was performed. There were on ly 11 articles, including our series, that reported outcomes of this proced ure. Among the 148 patients of this series, major neuromorbidity was 4.7%, and mortality occurred in 6.8% of the patients. Combined major neuromorbidi ty and mortality was 10.1%. Because total removal of the advanced cancer is the only therapy that can offer the patients a chance for cure, head and n eck surgeons should aggressively perform carotid resection and reconstructi on.