OBJECTIVEThe purpose of this study was to establish an ideal operation method to deal with head and neck carcinomas of late stage and involving the carotid.

METHODSA total of four metastasized head neck carcinomas involving the carotid arteries were included in this clinical trial. The primary tumors of the four cases tumors were carcinomas of tongue, esophagus, laryngeal and parotid glands. All four cases were examined by means of TCD, DSA, SPECT to confirm good compatibility of brain blood circulation before operations. The bony petrous sections of carotid arteries were drawn off after the exposure of the bone tissue for exterior skull. A by-pass was set up by inserting a shunt tube between the common carotid and the infernal carotid artery. The extended tumor resection was carried out involving the resection of the carotid artery. The artery was reconstructed with saphena magna vein transplantation in one case, and replaced by artificial vessels in two cases. Tissue defects were repaired by pedicle PMMF.

RESULTSThe B-typed ultrasound and TCD examination two weeks to six months post-operatively showed the four cases revealed good condition of transplanted carotid arteries, except one case occurred Honer's syndrome, but there was no central nerve's symptom or complication in the other three cases.

CONCLUSIONThis operation method could provide a good chance of survival by curettage of later staged head neck tumors. The authors recommend reconstruction of carotid artery in the operation treatment of malignant head neck carcinomas during late stages.