Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma
Background The primary objective is to identify clinical predictors of internal carotid artery (ICA) blowout in radiated nasopharyngeal carcinoma (NPC). Methods Seventeen ICA blowouts, 14 external carotid artery (ECA) bleeds, and 60 controls were identified from January 1, 2007 to July 31, 2020. Mul...
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| Veröffentlicht in: | Head & neck 2021-12, Vol.43 (12), p.3757-3763 |
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| container_title | Head & neck |
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| creator | Xu, Xinni Ong, Yew Kwang Loh, Woei Shyang Anil, Gopinathan Yap, Qai Ven Loh, Kwok Seng |
| description | Background
The primary objective is to identify clinical predictors of internal carotid artery (ICA) blowout in radiated nasopharyngeal carcinoma (NPC).
Methods
Seventeen ICA blowouts, 14 external carotid artery (ECA) bleeds, and 60 controls were identified from January 1, 2007 to July 31, 2020. Multinomial logistic regression was performed to identify features predictive of ICA blowouts.
Results
Headache was significantly more common among ICA blowouts than ECA bleeds and controls (58.8% vs. 7.1% vs. 6.7%, p |
| doi_str_mv | 10.1002/hed.26869 |
| format | Article |
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The primary objective is to identify clinical predictors of internal carotid artery (ICA) blowout in radiated nasopharyngeal carcinoma (NPC).
Methods
Seventeen ICA blowouts, 14 external carotid artery (ECA) bleeds, and 60 controls were identified from January 1, 2007 to July 31, 2020. Multinomial logistic regression was performed to identify features predictive of ICA blowouts.
Results
Headache was significantly more common among ICA blowouts than ECA bleeds and controls (58.8% vs. 7.1% vs. 6.7%, p < 0.001). The petrous skull base and sphenoid sinus lateral wall was eroded in all petrous and cavernous segment blowouts, respectively. Nasoendoscopy showing exposed clivus (OR 20.5, 95%CI 1.3–324.2) and computed tomography demonstrating skull base erosion (OR 17.8, 95%CI 1.0–311.0) were significantly associated with ICA blowouts compared to controls.
Conclusions
Findings of headache and skull base erosion on nasoendoscopy or imaging during NPC surveillance warrants prophylactic intervention to avoid an ICA blowout.</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.26869</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Carotid arteries ; Carotid artery ; carotid blowout ; Computed tomography ; factors ; Headache ; hemorrhage ; Nasopharyngeal carcinoma ; osteoradionecrosis ; Skull ; Throat cancer</subject><ispartof>Head & neck, 2021-12, Vol.43 (12), p.3757-3763</ispartof><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3309-d2a827d4f42fc3a9caf90e6f5249f40f0a795b32995dad4be91c3a7a9c0a53d33</citedby><cites>FETCH-LOGICAL-c3309-d2a827d4f42fc3a9caf90e6f5249f40f0a795b32995dad4be91c3a7a9c0a53d33</cites><orcidid>0000-0002-7534-2545</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.26869$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.26869$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids></links><search><creatorcontrib>Xu, Xinni</creatorcontrib><creatorcontrib>Ong, Yew Kwang</creatorcontrib><creatorcontrib>Loh, Woei Shyang</creatorcontrib><creatorcontrib>Anil, Gopinathan</creatorcontrib><creatorcontrib>Yap, Qai Ven</creatorcontrib><creatorcontrib>Loh, Kwok Seng</creatorcontrib><title>Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma</title><title>Head & neck</title><description>Background
The primary objective is to identify clinical predictors of internal carotid artery (ICA) blowout in radiated nasopharyngeal carcinoma (NPC).
Methods
Seventeen ICA blowouts, 14 external carotid artery (ECA) bleeds, and 60 controls were identified from January 1, 2007 to July 31, 2020. Multinomial logistic regression was performed to identify features predictive of ICA blowouts.
Results
Headache was significantly more common among ICA blowouts than ECA bleeds and controls (58.8% vs. 7.1% vs. 6.7%, p < 0.001). The petrous skull base and sphenoid sinus lateral wall was eroded in all petrous and cavernous segment blowouts, respectively. Nasoendoscopy showing exposed clivus (OR 20.5, 95%CI 1.3–324.2) and computed tomography demonstrating skull base erosion (OR 17.8, 95%CI 1.0–311.0) were significantly associated with ICA blowouts compared to controls.
Conclusions
Findings of headache and skull base erosion on nasoendoscopy or imaging during NPC surveillance warrants prophylactic intervention to avoid an ICA blowout.</description><subject>Carotid arteries</subject><subject>Carotid artery</subject><subject>carotid blowout</subject><subject>Computed tomography</subject><subject>factors</subject><subject>Headache</subject><subject>hemorrhage</subject><subject>Nasopharyngeal carcinoma</subject><subject>osteoradionecrosis</subject><subject>Skull</subject><subject>Throat cancer</subject><issn>1043-3074</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10E1LAzEQBuBFFKzVg_8g4EUP22aT7G5zlFqtUPCi5zDNh03ZJmuSUvrvTV1PgqcJk2cG5i2K2wpPKozJdKPVhDSzhp8VowrztsSUteenN6MlxS27LK5i3GKMacPIqLDzzjoroUN90MrK5ENE3iDrkg4utyUEn6xCEHLjiNadP_h9yv-oh2S1SxEdbNqgAMpC0go5iL7fQDi6Tz3MS-v8Dq6LCwNd1De_dVx8PC_e58ty9fbyOn9clZJSzEtFYEZaxQwjRlLgEgzHujE1YdwwbDC0vF5TwnmtQLG15lVmbYYYaqooHRf3w94--K-9jknsbJS668Bpv4-C1G3TME5xlendH7r1-9PVWTXVjBDScp7Vw6Bk8DEGbUQf7C4fKCosTqGLHLr4CT3b6WAPttPH_6FYLp6GiW9xeIUD</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Xu, Xinni</creator><creator>Ong, Yew Kwang</creator><creator>Loh, Woei Shyang</creator><creator>Anil, Gopinathan</creator><creator>Yap, Qai Ven</creator><creator>Loh, Kwok Seng</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7534-2545</orcidid></search><sort><creationdate>202112</creationdate><title>Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma</title><author>Xu, Xinni ; Ong, Yew Kwang ; Loh, Woei Shyang ; Anil, Gopinathan ; Yap, Qai Ven ; Loh, Kwok Seng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3309-d2a827d4f42fc3a9caf90e6f5249f40f0a795b32995dad4be91c3a7a9c0a53d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Carotid arteries</topic><topic>Carotid artery</topic><topic>carotid blowout</topic><topic>Computed tomography</topic><topic>factors</topic><topic>Headache</topic><topic>hemorrhage</topic><topic>Nasopharyngeal carcinoma</topic><topic>osteoradionecrosis</topic><topic>Skull</topic><topic>Throat cancer</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xu, Xinni</creatorcontrib><creatorcontrib>Ong, Yew Kwang</creatorcontrib><creatorcontrib>Loh, Woei Shyang</creatorcontrib><creatorcontrib>Anil, Gopinathan</creatorcontrib><creatorcontrib>Yap, Qai Ven</creatorcontrib><creatorcontrib>Loh, Kwok Seng</creatorcontrib><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Xinni</au><au>Ong, Yew Kwang</au><au>Loh, Woei Shyang</au><au>Anil, Gopinathan</au><au>Yap, Qai Ven</au><au>Loh, Kwok Seng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma</atitle><jtitle>Head & neck</jtitle><date>2021-12</date><risdate>2021</risdate><volume>43</volume><issue>12</issue><spage>3757</spage><epage>3763</epage><pages>3757-3763</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><abstract>Background
The primary objective is to identify clinical predictors of internal carotid artery (ICA) blowout in radiated nasopharyngeal carcinoma (NPC).
Methods
Seventeen ICA blowouts, 14 external carotid artery (ECA) bleeds, and 60 controls were identified from January 1, 2007 to July 31, 2020. Multinomial logistic regression was performed to identify features predictive of ICA blowouts.
Results
Headache was significantly more common among ICA blowouts than ECA bleeds and controls (58.8% vs. 7.1% vs. 6.7%, p < 0.001). The petrous skull base and sphenoid sinus lateral wall was eroded in all petrous and cavernous segment blowouts, respectively. Nasoendoscopy showing exposed clivus (OR 20.5, 95%CI 1.3–324.2) and computed tomography demonstrating skull base erosion (OR 17.8, 95%CI 1.0–311.0) were significantly associated with ICA blowouts compared to controls.
Conclusions
Findings of headache and skull base erosion on nasoendoscopy or imaging during NPC surveillance warrants prophylactic intervention to avoid an ICA blowout.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><doi>10.1002/hed.26869</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7534-2545</orcidid></addata></record> |
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| issn | 1043-3074 1097-0347 |
| language | eng |
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| source | Wiley Journals |
| subjects | Carotid arteries Carotid artery carotid blowout Computed tomography factors Headache hemorrhage Nasopharyngeal carcinoma osteoradionecrosis Skull Throat cancer |
| title | Clinical predictors of internal carotid artery blowout in patients with radiated nasopharyngeal carcinoma |
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