Balloon Test Occlusion in Temporal Bone Tumors

The surgical treatment of hypervascular or invasive temporal bone tumors has a number of endovascular considerations. Surgical treatment may involve a planned preoperative tumor embolization or an inadvertent carotid injury. Some tumors may not be a good target for embolization, and preoperative carotid occlusion might be considered. It is advantageous to understand the patient’s ability to tolerate carotid sacrifice prior to surgery, and this can be assessed through a carotid balloon test occlusion. This chapter describes the indications and technique for performing a carotid balloon test occlusion, as well as the relevant vascular anatomy and collateral circulation necessary for a patient to tolerate occlusion.