En bloc resection of the carotid axis in epidermoid carcinoma of the head and neck. Retrospective analysis of 7 cases

En bloc resection of carotid artery involved by squamous cell carcinoma was performed in 7 patients from 1993 to 1997. Cerebral tolerance was tested with qualitative evaluation of cerebral blood flow during preoperative balloon test occlusion of the internal carotid artery. Four patients later underwent permanent carotid occlusion prior to en bloc resection, 2 patients underwent carotid ligation without reconstruction and one patient underwent carotid resection associated with carotid reconstruction. The preliminary neurovascular and carcinologic results are presented. One patient had definitive stoke postoperatively. Follow-up ranged from 3 to 34 months. Two patients died by the 6th and 26th postoperative month respectively. Among the remaining 5 patients, tumoral recurrence occurred in two. Two patients have survived more than 2 years, but one of them had local recurrence and distant metastases. Considering these data and the review of the literature, selection of patients after carcinologic and cerebral tolerance evaluation is important in order to improve survival and quality of life of these patients.