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Melachuri S, Melachuri M, Vallapil B, et al. The incidence of stroke post neck dissection surgery and perioperative management. Am J Otolaryngol. 2021;43(2):103360doi: 10.1016/j.amjoto.2021.103360.
Melachuri, S., Melachuri, M., Vallapil, B., Kim, S., & Snyderman, C. (2021). The incidence of stroke post neck dissection surgery and perioperative management. American journal of otolaryngology, 43(2), 103360. https://doi.org/10.1016/j.amjoto.2021.103360
Melachuri, Samyuktha, et al. "The incidence of stroke post neck dissection surgery and perioperative management." American journal of otolaryngology vol. 43,2 (2021): 103360. doi: https://doi.org/10.1016/j.amjoto.2021.103360
Melachuri S, Melachuri M, Vallapil B, Kim S, Snyderman C. The incidence of stroke post neck dissection surgery and perioperative management. Am J Otolaryngol. 2021 Dec 24;43(2):103360. doi: 10.1016/j.amjoto.2021.103360. Epub 2021 Dec 24. PMID: 34972004.
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Am J Otolaryngol. 2021 Dec 24;43(2):103360. doi: 10.1016/j.amjoto.2021.103360. Epub 2021 Dec 24.

The incidence of stroke post neck dissection surgery and perioperative management.

American journal of otolaryngology

Samyuktha Melachuri, Manasa Melachuri, Benita Vallapil, Seungwon Kim, Carl Snyderman

Affiliations

  1. University of Pittsburgh Medical Center Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA.
  2. Northeast Ohio Medical University, University of Pittsburgh, Pittsburgh, PA, USA.
  3. University of Pittsburgh Medical Center Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: [email protected].

PMID: 34972004 DOI: 10.1016/j.amjoto.2021.103360

Abstract

BACKGROUND: Head and neck surgery encompasses major vessels, raising the concern of life-threatening complications such as stroke.

METHODS: Databases at UPMC were queried to identify patients with both neck dissections and stroke from January 1st, 2004, to October 1st, 2020. A retrospective chart review was performed to identify patients who experienced a stroke within 30 days of a neck dissection.

RESULTS: Search of a UPMC database for carotid artery stenosis (CAS), transient ischemic attack (TIA), and stroke identified 20,527 patients. After matching with the Head and Neck Tumor Registry patients, 41 of 4230 patients with a neck dissection also had a stroke, TIA, or CAS in their lifetime. One patient, with multiple risk factors, despite pre-operative precautions, had a stroke 2 days post neck dissection in the setting of carotid occlusion from hypercoagulability of malignancy and intraoperative vessel injury. The patient subsequently underwent a carotid thrombectomy and vein patch repair and has had no additional cerebrovascular accidents.

CONCLUSION: Although the incidence of stroke post neck dissection is minimal, patients with multiple risk factors for stroke should be managed carefully to prevent deleterious outcomes.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: Carotid artery stenosis; Neck dissection; Stroke; Transient ischemic attack

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