Carotid Artery Injury After Endonasal Surgery

Rowan Valentine, Peter Wormald

    Research output: Contribution to journalArticlepeer-review

    71 Citations (Scopus)


    Carotid artery injury during endonasal surgery is the most feared and catastrophic complication. Internal carotid artery injury is more frequent during skull base surgery, and risk factors include acromegaly, previous revision surgery, and prior radiotherapy and bromocriptine therapy. Nasal packing is frequently used to gain hemostasis, often resulting in vascular occlusion. Recent research recommends the crushed muscle patch treatment as an effect hemostat that maintains vascular patency. Endovascular techniques are recommended for vascular control and complication management. Coil or balloon embolization is preferred in patients with adequate collateral cerebral blood flow, and stent-graft placement or bypass surgery is indicated in those who do not.

    Original languageEnglish
    Pages (from-to)1059-1079
    Number of pages21
    JournalOtolaryngologic Clinics of North America
    Issue number5
    Publication statusPublished - Oct 2011


    • Carotid artery injury
    • Endoscopic
    • Hemostasis
    • Pseudoaneurysm
    • Transphenoidal


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