Resection of the internal carotid artery in selected patients affected by cancer of the skull base

Marco Ferrari, Elisabetta Zanoletti, Stefano Taboni, Diego Cazzador, Giulia Tealdo, Alberto Schreiber, Davide Mattavelli, Vittorio Rampinelli, Francesco Doglietto, Marco Maria Fontanella, Barbara Buffoli, Alperen Vural, Vincenzo Verzeletti, Andrea Luigi Camillo Carobbio, Dikran Mardighian, Francesco Causin, Ester Orlandi, Marco Cenzato, Rita Rezzani, Piero Nicolai

Research output: Contribution to journalArticle

Abstract

Invasion of the internal carotid artery (ICA) has been historically considered a criterion of non-resectability of skull base cancer (SBC). Patients affected by SBC who underwent surgery including resection of ICA at two tertiary institutions were included. Demographics, oncologic, and surgical information, complications, and survival outcomes were retrospectively reviewed. Survival outcomes were calculated. Ten patients were included. Three surgical approaches (transnasal endoscopic, transorbital, and transpetrosal) were employed to resect the invaded/abutted tract(s) of the ICA. All patients underwent ICA temporary balloon occlusion test. In two patients, an extracranial-to-intracranial arterial bypass was harvested. Major neuromorbidity was observed in two patients. Perioperative mortality of the series was 10.0%. Mean overall survival was 27.2 months, with 2-year overall and progression-free survival rate of 88.9%. ICA resection is feasible as part of the ablation performed for very advanced SBCs. Survival outcomes are acceptable in adequately selected patients.
Original languageEnglish
Pages (from-to)1030-1042
Number of pages13
JournalHEAD & NECK
Volume44
DOIs
Publication statusPublished - 2022

Keywords

  • cancer
  • head and neck
  • internal carotid artery
  • skull base
  • vascular surgical procedure
  • Head and Neck Neoplasms
  • Humans
  • Retrospective Studies
  • Skull Base
  • Cerebral Revascularization
  • Carotid Artery, Internal

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