RESULTS
Demographics, previous N stage, type of surgery, time to recurrence and time to carotid rupture of 8 patients were presented in Table 1. All of the patients in this study were type III CBS and managed by carotid artery ligation. Age of the patients was between 54 and 69 with a mean of 62.75±5.6 years.
All of the patients had untreatable locoregional recurrence. Primary site was oral cavity in 3(37.5%), oropharynx-hypopharynx in 3(37.5%) and larynx in 2(25%) patients with primary N stages as N1 in 1(12.5%), N2 in 3(37.5%) and N3 in 4(50%) patients. Three patients(37.5%) had previous radiotherapy or chemoradiotherapy for curative intent. Five patients (62.5%) had surgery and postoperative adjuvant treatment, radical neck dissection was performed in 3 (60%) and functional neck dissection was performed in 2(40%)(Table 1). Time to recurrence following primary treatment was between 6-19 months with a mean of 8.25±5.11 months. Apart from tumor infiltration seen in all of the patients, three had fistula, 5 had wound infection and 6 had necrosis at bleeding site(Table 1). Bleeding was from CCA near bifurcation in 5(62.5%), ICA in 2(25%) and from main trunk of external carotid artery just above bifurcation in one(12.5%) patient(Table 1). Time from detection of recurrence-soft tissue exposure to CBS was ranging from 2 to 12 months with a mean of 5.37±3.11 months and in patients having fistula and necrosis blow-out was earlier(6 patients; 2-4 with a mean of 4±1.2 months). Postoperatively 2 patients had major neurologic morbidity (hemiplegia; 25%). In postoperative follow-up period 7 patients were detected to be deceased(87.5%) and mean time to death was 7.71±6.15 months(1-17 months).