EC-IC Bypass for Skull Base Necrosis and ICA Rupture Hemorrhage After Radiotherapy for Nasopharyngeal Carcinoma.

Abstract

Background: Skull base necrosis can cause life-threatening massive bleeding in patients following radiotherapy and chemotherapy for nasopharyngeal carcinoma. Patients with bilateral internal carotid artery rupture and hemorrhage are especially susceptible, which is a major challenge for clinicians.

Methods: A team at the Eye and ENT Hospital affiliated with Fudan University recently successfully treated a patient with skull base necrosis after radiotherapy and chemotherapy for nasopharyngeal carcinoma. The patient experienced bilateral internal carotid artery rupture with massive nasopharyngeal hemorrhage and was treated with extracranial-intracranial bypass surgery, resection of the nasal skull base necrotic lesions, and bilateral internal carotid artery occlusion.

Results: One week after the last surgery, the patient recovered well, and normal activity was restored.

Conclusions: Simultaneous EC-IC bypass and TMF repair increase intracranial blood flow compensation without the need for an additional incision, saving the patient's life and improving their quality of life. These results highlight a promising surgical practice for rescuing patients suffering from skull base necrosis and ICA rupture hemorrhage.