External Carotid Artery Ligation: A Report Of Four Cases

Abstract

External carotid artery ligation is an uncommon surgical procedure, although its use as a life saving measure either preemptively or in an emergent situation has been reported in literature. The cervico-orofacial region is highly vascularized, therefore surgeries involving this region may be occasioned by excessive hemorrhage. In addition, certain tumours of the cervico-orofacial region have a propensity for extreme hemorrhage, especially when large. Carotid blow out may also constitute an emergency that requires immediate remediation.
We report 4 cases where ligation of the external carotid artery was done with the aim of controlling hemorrhage. The patients were aged 8-45 years, with a median age 21.5 years. One case of carotid blow out secondary to an infected mandibular fracture, two cases of ossifying fibroma and one case of osteogenic sarcoma were included in this study. Two of the patients had temporary external carotid artery ligation, while the others had permanent ligation. Subsequent reviews were satisfactory and no complication was recorded.
Hemorrhagic shock is a formidable cause of mortality in our environment. Although other modes of controlling hemorrhage arising from maxillofacial surgeries / injuries exist, their availability/accessibility may be a challenge. External carotid artery ligation offers a relatively obtainable alternative to other techniques of hemorrhage control.