Shah Purva C, Shah Chetan K, Jindal Himanshu
Department of Internal Medicine, Baroda Medical College, MS University, Vadodara, IND.
Department of Anesthesiology, HCG Cancer Hospital, Vadodara, IND.
Cureus. 2022 Mar 21;14(3):e23356. doi: 10.7759/cureus.23356. eCollection 2022 Mar.
Laryngectomy is a common surgery for an oncosurgeon, but underlying carotid compromise is a serious concern for anesthesiologists, making this routine procedure a high-risk one. The utmost vigilance of the anesthesiologist is demanded by the surgery to prevent morbidities such as hemiplegia, hemiparesis, or speech abnormalities that may occur due to perfusion insufficiency secondary to the mechanical blockage of the carotid arteries. Hence, an undiagnosed case of carotid artery block may result in disastrous consequences for the patient, surgeon, and anesthesiologist. Hence, it is imperative to perform all the pre-operative investigations with due diligence. We present the case of a 74-year-old male who was admitted to our set-up for laryngeal carcinoma surgery. The patient had received chemoradiotherapy (CRT) six months earlier. He complained of hoarseness in his voice and a painless neck mass. He was a known case of hypertension for 14 years, controlled by oral medication, and had a history of stroke five years ago, when he was also diagnosed with a completely blocked right common carotid artery (CCA) and a partially blocked left common carotid artery.
喉切除术是肿瘤外科医生的常见手术，但潜在的颈动脉受压是麻醉医生严重关切的问题，这使得这个常规手术成为高风险手术。该手术要求麻醉医生保持高度警惕，以预防因颈动脉机械性阻塞继发灌注不足而可能发生的偏瘫、半身不遂或言语异常等并发症。因此，未诊断出的颈动脉阻塞病例可能会给患者、外科医生和麻醉医生带来灾难性后果。因此，必须认真进行所有术前检查。我们报告一例74岁男性患者，因喉癌手术入住我院。该患者六个月前接受了放化疗（CRT）。他主诉声音嘶哑和无痛性颈部肿块。他已知患有高血压14年，通过口服药物控制，并且五年前有过中风史，当时他还被诊断出右颈总动脉（CCA）完全阻塞，左颈总动脉部分阻塞。
