Value of Angiography in the Management of Tumors of the Head and Neck

Abstract

In the past 5 years both carotid and retrograde brachial arteriography have been employed in the management of certain selected extracranial neoplastic lesions in the region of the head and neck. This was done in an attempt to assess the value of angiography in the management of extracranial tumors. It was found that certain masses, for example, carotid body tumors, have a typical angiographic appearance, while others are less specific. The majority of neck lesions will displace arteries but have no abnormal vascular architecture. Angiography is of value in the differential diagnosis of some of these which may resemble each other clinically. Some large tumors of the neck may compress or even partially occlude the carotid artery. Invading lesions of the vault or base may extend intracranially and show features of extradural extension which may be demonstrated by angiography. During surgery direct trauma to the carotid artery may lead to occlusive disease and cerebral infarction demonstrable by angiography. In patients with known carcinoma, arteriography may aid in the differential diagnosis of intracranial complications. Angiography is of assistance in the selection of the most suitable artery for regional intra-arterial infusion technics. It is concluded that the full demonstration of both the normal and pathological arterial system is of fundamental importance in the correct handling of selected extracranial tumors. There are many other indications for arterial study in both the pre- and postoperative periods.