Carotid blowout syndrome in patients treated by larynx cancer

Abstract Introduction: Carotid blowout syndrome is an uncommon complication for patient treated by head and neck tumors, and related to a high mortality rate. Objective: The aim of this study was to study the risk of carotid blowout in a large cohort of patients treated only by larynx cancer. Methods: Retrospective analysis of patients older than 18 years, treated by larynx cancer who developed a carotid blowout syndrome in a tertiary academic centre. Results: 197 patients met the inclusion criteria, 192 (98.4%) were male and 5 (1.6%) were female. 6 (3%) patients developed a carotid blowout syndrome, 4 patients had a carotid blowout syndrome located in the internal carotid artery and 2 in the common carotid artery. According to the type of rupture, 3 patients suffer a type I, 2 patients a type III and 1 patient a type II. Five of those patients had previously undergone radiotherapy and all patients underwent total laryngectomy. We found a statistical correlation between open surgical procedures (p = 0.004) and radiotherapy (p = 0.023) and the development of a carotid blowout syndrome. Conclusion: Carotid blowout syndrome is an uncommon complication in patients treated by larynx tumours. According to our results, patient underwent radiotherapy and patients treated with open surgical procedures with pharyngeal opening have a major risk to develop this kind of complication.

摘要：
引言：颈动脉破裂综合征（Carotid blowout syndrome）是头颈部肿瘤患者接受治疗时的罕见并发症，且与较高的死亡率相关。
研究目的：本研究旨在探究仅接受喉癌治疗的大队列患者中，颈动脉破裂综合征的发病风险。
研究方法：对某三级学术医疗中心内年龄≥18岁、接受喉癌治疗且发生颈动脉破裂综合征的患者开展回顾性分析。
研究结果：共计197例患者符合纳入标准，其中192例（98.4%）为男性，5例（1.6%）为女性。6例（3%）患者发生颈动脉破裂综合征，其中4例的破裂部位为颈内动脉（internal carotid artery），2例为颈总动脉（common carotid artery）。按破裂类型划分，3例为I型，2例为III型，1例为II型。其中5例患者此前接受过放射治疗，所有患者均接受了全喉切除术（total laryngectomy）。本研究发现，开放性手术操作（p = 0.004）与放射治疗（p = 0.023）与颈动脉破裂综合征的发生存在统计学相关性。
研究结论：颈动脉破裂综合征是喉癌患者接受治疗时的罕见并发症。根据本研究结果，接受放射治疗的患者，以及接受伴咽腔开放的开放性手术治疗的患者，发生此类并发症的风险更高。