EXTERNAL CAROTID ARTERY LIGATION: AN ONCOLOGICAL EMERGENCY PROCEDURE FOR BLEEDING LOCALLY ADVANCED ORAL CANCERS IN A TERTIARY CARE HOSPITAL IN CENTRAL INDIA

Abstract

Introduction: Oral cancer is a major public health problem in the Indian subcontinent. Bleeding is a frequent life-threatening problem for patients with advanced oral cancer. We in this study discuss our experience with bleeding locally advanced oral cavity cancers presenting to us in the emergency whereby we have performed surgical management in the form of external carotid artery (ECA) ligation.

Methodology: We performed are trospective observational study of Emergency ECA ligation at our institute from October 2019 to October2021. All patients were diagnosed case of oral squamous cell carcinoma (SCC) presented with severe life-threatening oral bleeding in the emergency department. Initially patients were resuscitated with IV fluids and blood products and oral cavity were packed with pressure dressings and patients immediately shifted to emergency operating room where we performed tracheostomy followed by external carotid artery ligation.

Results: A total of 14 patients underwent emergency ECA ligation. Out of which 12 were male patients and average age was 46 years. 12 out of 14 patients had locally advanced carcinoma (Ca) tongue and 2 patients had locally advanced Ca buccal mucosa. Following ECA ligation of all 14 patients, bleeding had stopped in the immediate post-operative day. Patients were discharged without any postoperative morbidity or mortality. No patient had any neurologic deficits postoperatively.

Conclusion: We conclude that ECA ligation in conjugation with tracheostomy is a very simple and life-saving procedure for locally advanced oral cancer patients presenting in the emergency department with severe life-threatening bleeding.