Rupture of the common carotid artery is one of the most feared postoperative complications of neck dissection. A 55-year-old-male patient with carcinoma of the hypopharynx (T4N2cM0) underwent a total pharyngolaryngoesophagectomy, radical neck dissection on the right side and conservative neck dissection on the left side. Ten days later the right common carotid artery ruptured. We suspect that the artery rupture was secondary to MRS A infection. Ligation of right common carotid artery was performed and the patient survived without neurological problems. In order to determine the safety of resection of a common carotid artery, we measured stump pressure and monitored electroencephalogram changes during surgery. The incidence and risk factors of carotid artery rupture are discussed. To our knowledge, this is the first report of carotid artery rupture due to MRS A infection.
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