Pre-reconstruction of cervical-to-petrous internal carotid artery: An improved technique for treatment of vascular lesions involving internal carotid artery at the lateral skull base

Background Reconstruction of the internal carotid artery (ICA) is an operative challenge for lesions involving the lateral skull base because of excessive blood loss, intraoperative cranial nerve injury, and difficulties in cerebral protection. Methods Between January 2010 and October 2014, 9 patients with vascular lesions at the lateral skull base were treated with a “pre-reconstruction” technique, which means reconstruction of the ICA in advance of excising the lesions. Results All operations were technically successful with no mortality or strokes. The mean blood loss was 921 ± 210 mL. The mean total clamping time was 18 ± 5 minutes. Among the 5 patients without invasion of specific cranial nerves, no long-term sequelae occurred during the follow-up period ranging from 11 to 54 months. Conclusion With less blood loss, slighter cranial nerve injuries, and shorter clamping time, the “pre-reconstruction” technique was safe and effective for the treatment of vascular lesions at the lateral skull base. © 2016 Wiley Periodicals, Inc. Head Neck, 2016