Multistep and Multidisciplinary Management for Post-irradiated Carotid Blowout Syndrome in a Young Patient With Oropharyngeal Carcinoma: A Case Report.

Background: Carotid blowout syndrome is a severe complication of head and neck cancer, associated with high mortality and morbidity.

Methods: We present a case of acute hemorrhage from the carotid artery of a 59-year-old man with a history of chemoradiotherapy for lingual base and oropharyngeal squamous cell carcinoma. The case was managed by a staged multidisciplinary approach of open arterial reconstruction, after initial endovascular hemorrhage control using stent graft.

Temporal bone resection for lateral skull-base malignancies.

Introduction: Malignancies involving the temporal bone are increasingly common and require specialized multi-disciplinary care. Given this complex location, involvement of the lateral skull base and local neurovascular structures is common. In this review we discuss general principles for temporal bone resection, as well as alternative and complementary surgical approaches that should be considered in the management of patients with temporal bone cancer.

Tandem occlusion involving accessory middle cerebral artery in acute ischaemic stroke: management strategies.

Occlusion of both the limbs of accessory middle cerebral artery (AMCA) poses a unique challenge in management of acute ischaemic stroke by mechanical thrombectomy. The patient is a 30-year-old man, presenting with acute onset of left-sided hemiparesis for 4 hours. Non-contrast CT brain showed no bleed and three-dimensional CT angiogram of head and neck vessels showed dissection involving right carotid bulb and tandem occlusion of right MCA with presence of two MCA stumps.

Carotid Body Tumor Microenvironment.

Carotid body tumors (CBTs) are rare paragangliomas, comprising 0.5% of all head and neck tumors, and 65% of head and neck paragangliomas. A majority of CBTs occur sporadically, while 15% are familial or hyperplastic in the setting of chronic hypoxia.

Flow Diversion for Intracranial Aneurysm Treatment: Trials Involving Flow Diverters and Long-Term Outcomes.

Flow diverters (FDs) have changed the management of brain aneurysms; not only for complex aneurysms (giant, fusiform and blister) refractory to conventional therapies, but also for unruptured lesions previously managed by traditional surgical or coil-based endovascular methods. Since 2011 when the PipelineTM Embolization Device (Medtronic) was cleared by the Food and Drug Administration for adults with large or giant wide-neck intracranial aneurysms of the internal carotid artery proximal to the posterior communicating segment, the role of flow diversion for aneurysm treatment has expanded-supported by favorably low complication and high cure rates compared with alternative treatments. Here we review the key clinical trials and the long term outcomes that have demonstrated safety and efficacy of minimized porosity endoluminal devices in the treatment of cerebral aneurysms.

A Rare Case of Locally Advanced Recurrent Neuroendocrine Tumour of Neck Salvaged by a Radical Surgical Approach.

Neuroendocrine tumours of head and neck are rare neoplasms and even more rare are those of cutaneous adenoid cystic carcinoma with neuroendocrine differentiation. Virtually every known variant of neoplasia with neuroendocrine differentiation can arise in complex structures of head and neck (Mills in Endocr Pathol 7(4):329-343. doi:10.

Bilateral Carotid Patch Infection Occurring 12 years Following Endarterectomy.

Background: Carotid endarterectomy (CEA) is the most commonly used invasive procedure for treatment of carotid stenosis. Different methods are used to close the arteriotomy including primary closure and patch repair with a graft. Prosthetic patch infection is a rare but serious complication of patch closure, and we will present a unique case of carotid patch infection (CPI) 12 years after implantation.

Carotid Artery Aneurysm in HIV: A Review of Case Reports in Literature.

Background: HIV infection may affect the cardiovascular system through different physiopathological patterns. Rarely reported in HIV negative patients, aneurysms involving the carotid artery have been described for the first time in seropositive patients in 1989.

Aims: In our study, we have focused on aneurysm pathology affecting carotid arteries in HIV patients, analyzing clinical and surgical presentation, management, and outcome, through a review of cases published in the literature.

The Outcome of Multidisciplinary Management of Carotid Body Tumors: Retrospective Cohort Study.

Background: Carotid body tumor (CBT) is a rare paraganglionic hyper-vascular tumor of the carotid body. The standard treatment for CBTs is surgery, but it involves risk. The study is aimed to assess the CBTs and evaluate the outcome of multidisciplinary management.

Horner Syndrome from a Pediatric Otolaryngology Perspective.

Introduction: Horner syndrome is described as the clinical triad of miosis, ptosis, and anhidrosis. In pediatric patients the condition may be congenital or acquired from neoplastic, infectious or traumatic conditions, including birth trauma. Most cases of pediatric Horner syndrome present first to a pediatric ophthalmologist however since the neural pathways involve the cervical sympathetic chain otolaryngologists should understand the pathophysiology to avoid delay in management of potentially malignant cases.

Mycotic Pseudoaneurysm of Internal Carotid Artery Induced by Skull Base Osteomyelitis.

Background: Skull base osteomyelitis (SBO) is predominantly seen in immunocompromised patients, with diabetes mellitus being the most common underlying comorbidity. Microbial aetiology is commonly bacterial, although fungal SBO is encountered in a small fraction of patients. Treatment consists of prolonged antimicrobial therapy, control of underlying comorbidity, and surgical debridement in selected cases.

[Surgical Management of a Thromobotic Extracranial Carotid Artery Aneurysm:A Case Report].

Extracranial carotid artery aneurysms are relatively rare. We present a case involving a giant aneurysm arising from the extracranial carotid artery. The patient was a 79-year-old woman.

A Transoral Excision of a Deep Parotid Lobe Lesion Using Ultrasound-Guided Wire Localization: A Multi-disciplinary Team Approach.

Purpose: Removing deep parotid lobe lesions often requires a mandibulotomy procedure which carries with it a risk of significant morbidity. A transoral approach may help mitigate against complications but is technically demanding due to limited access in an area with a close relation to the internal carotid artery.

Methods: We describe a multi-disciplinary approach with the use of intraoral ultrasound-guided wire localization of a low-grade acinic cell carcinoma located in the deep lobe of the right parotid gland.

Imaging Spectrum of Cavernous Sinus Lesions with Histopathologic Correlation.

Cavernous sinuses are paired interconnected venous plexuses situated in the floor of the middle cranial fossa on either side of the sella turcica and sphenoid sinus. They are lined by dura mater and consist of multiple venous channels within. The cavernous sinuses are intimately related to the internal carotid artery and its associated sympathetic plexus, the oculomotor nerve, the trochlear nerve, the abducens nerve, and the ophthalmic nerve.

Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report.

Background: A giant congenital cervical teratoma is often highly vascularized; thus, in addition to a life-threatening airway occlusion at birth it comprises a high risk for significant and lethal blood loss during resection. In the case presented, an endovascular embolization of the carotid artery that supplied a giant congenital cervical teratoma was done as part of a three-stage treatment soon after birth and contributed to an overall good outcome. Embolization in cases of cervical teratomas was not described previously.

Ischemic stroke and floating thrombosis in dissection of the common carotid artery in patient at third week of pregnancy: Surgical technical success and maintenance of pregnancy.

Thrombosis, especially in pregnancy, is due to a prothrombotic state and involves the venous system. Localization in an arterial segment is rare. Floating carotid arterial thrombosis is a very rare occurrence, but it is very devastating.

Transcervical Carotid Artery Stenting Without Flow Reversal: A Report of Two Cases.

BACKGROUND The use of a carotid artery stent (CAS) is a management option for high-risk patients with carotid artery stenosis. An access site for CAS that involves the transcervical approach may be performed percutaneously or may require a cutdown, and usually includes a flow-reversal system to reduce the risk of embolization. Two cases are presented where the transcervical approach to CAS incorporated a distal filter for embolic protection, with a successful outcome.

Vascular interventions in head and neck cancer patients as a marker of poor survival.

Objective: Head and neck cancer can involve the surrounding vasculature and require technically challenging vascular interventions. These interventions can be complicated by tumor invasion, history of prior surgery, and history of radiation therapy. Our aim was to examine patients with vascular interventions in association with head and neck cancer to determine outcomes and best practice.

Multimodal management of pediatric carotid body tumors: a systematic review and case illustrations.

OBJECTIVE Carotid body tumors (CBTs), extraadrenal paragangliomas, are extremely rare neoplasms in children that often require multimodal surgical treatment, including preoperative anesthesia workup, embolization, and resection. With only a few cases reported in the pediatric literature, treatment paradigms and surgical morbidity are loosely defined, especially when carotid artery infiltration is noted. Here, the authors report two cases of pediatric CBT and provide the results of a systematic review of the literature.

Carotid Artery Involvement in Advanced Recurrent Head and Neck Cancer: A Case Report and Literature Review.

Background: Surgical management of advanced head and neck tumors involving the carotid artery remains controversial with compromised survival outcomes and heightened risks of morbidity and mortality.

Case: We describe a case of a 74-year-old lady with previous T1N0M0 left tongue squamous cell carcinoma, who developed a left nodal recurrence encasing the left external carotid artery from the carotid bifurcation. She underwent an extended left radical neck dissection with carotid artery patch plasty and remains well to date, 10 months after surgery.

Data Set for the Reporting of Ear and Temporal Bone Tumors: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting.

The International Collaboration on Cancer Reporting (ICCR) was established to internationally unify and standardize the pathologic reporting of cancers based on collected evidence, as well as to allow systematic multi-institutional intercountry data collection to guide cancer care in the future. Such collaborative efforts are particularly essential for developing an evidence base for rare neoplasms or those with marked geographic variation in incidence, such as the tumors of the ear and the temporal bone. The ear and the temporal bone, including the external auditory canal and the middle and inner ear, with the closely associated facial nerve, internal carotid artery, and internal jugular vein, is one of the most complex anatomic structures in the head and neck.

Imaging Spectrum of TIPIC Syndrome : Validation of a new Entity with Vessel Wall Imaging.

Purpose: Acute neck pain can have non-vascular and vascular causes. Some patients present with distinct vascular and perivascular changes on imaging at the site of tenderness. This study aimed to evaluate the imaging findings of transient perivascular inflammation of the carotid artery (TIPIC) syndrome with an emphasis on vessel wall imaging using 3‑Tesla (3-T) high-resolution (HR) magnetic resonance imaging (MRI).

Endoscopic Endonasal Versus Transorbital Surgery for Middle Cranial Fossa Tumors: Comparison of Clinical Outcomes Based on Surgical Corridors.

Background: Based on our experience with the endoscopic endonasal approach (EEA) and transorbital approach (TOA) for middle cranial fossa tumors, we evaluated the efficacy and limitations of visualization and the clinical outcomes associated with the approaches depending on the surgical corridors. In addition, we determined the optimal strategy for each approach.

Methods: Between September 2015 and May 2018, we retrospectively reviewed clinical outcomes in 21 patients who underwent minimally invasive endoscopic surgery for middle cranial fossa tumors involving the cavernous sinus.

Surgical Management of Parapharyngeal Space Tumours in a Single Tertiary Care Center.

Because of the inaccessibility and overcrowding of the vital neurovascular structures, management of the parapharyngeal space (PPS) tumour is always a challenge to the surgeons. Here we have discussed the clinical findings and management of the PPS tumours with special concern to the surgical approaches. It is a retrospective study containing 14 patients of PPS tumour from June 2015 to January 2018 in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care referral hospital.

The Headache and Neck Pain in Ischemic Stroke Patients Caused by Cervicocerebral Artery Dissection. A Case-Control Study.

Background And Purpose: The symptom of headache and neck pain is common in patients with cervicocerebral artery dissection (CAD). We attempt to screen ischemic stroke patients with CAD based on the characteristics of the pain.

Methods: Eighty-one consecutive ischemic stroke patients with CAD from 2010 to 2017 and 84 consecutive ischemic stroke patients with large artery atherosclerosis (LAA) were registered prospectively and observed in Zhengzhou, China.