Pharyngo-carotid fistula and Acute Carotid Blowout Syndrome after “salvage” total laryngectomy: A Case Report

Abstract

Objectives: Acute Carotid Blowout Syndrome (ACBS) is an uncommon but feared complication of head and neck cancers. We present a rare Case of ACBS secondary to a pharyngo-carotid fistula post “salvage” total laryngectomy. Case report: A 45-year-old man with a history of glottic squamous cell carcinoma presented with massive transoral bleeding following total salvage laryngectomy. Imaging revealed ACBS of the ipsilateral common carotid artery, the patient underwent emergent coil embolization, and hemostasis was achieved without any neurological deficits. Further management required coil extraction and flap reconstruction due to coil extrusion. Conclusion: ACBS is a life-threatening complication of head and neck cancers which requires preventive measures as well as prompt identification and intervention to prevent fatal hemorrhaging or grave neurological morbidity.

Keywords

• Carotid blowout
• Carotid artery embolization
• Laryngeal cancer
• Salvage laryngectomy