Skip to main content
SpringerLink
Log in

Emergency in Head and Neck Cancer Patients

  • Chapter
  • First Online:
Oncologic Surgical Emergencies

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

  • 231 Accesses

Abstract

Acute airway obstruction, several bleeding, and infectious emergencies are the most frequent emergencies in head and neck cancer patients. Their management is described in this section of the book. Firstly, the management of the airway obstruction is considered because actually all these emergencies could evolve in it. Some protocols are provided in order to simplify the administration of the patient who has a severe dyspnea. The first choice in the management of airway obstruction should be the intubation of the patient whenever it is possible; on the contrary, a cricothyrotomy or a tracheotomy should be performed. In case of severe bleeding, there are different possibilities of management according to the origins, either surgical or radiological. An infection could be treated initially with medical care, but if it is insufficient, a surgical management will be required.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Fischbein N, Murr A. Imaging traumatic and nontraumatic neck emergencies in the adult. Emerg Radiol. 1999;6:94–109. https://doi.org/10.1007/s101400050033.

    Article  Google Scholar 

  2. Arné J, Descoins P, Fusciardi J, Ingrand P, Ferrier B, Boudigues D, et al. Preoperative assessment for difficult intubation in general and ENT surgery: predictive value of a clinical multivariate risk index. Br J Anaesth. 1998;80(2):140–6.

    Article  PubMed  Google Scholar 

  3. Bansal A, Miskoff J, Lis RJ. Otolaryngologic critical care. Crit Care Clin. 2003;19(1):55–72.

    Article  PubMed  Google Scholar 

  4. Garantziotis S, Kyrmizakis DE, Liolios AD. Critical care of the head and neck patient. Crit Care Clin. 2003;19(1):73–90.

    Article  PubMed  Google Scholar 

  5. Bhatnagar S, Mishra S, Jha RR, Singhal AK, Bhatnagar N. The LMA Fastrach facilitates fibreoptic intubation in oral cancer patients. Can J Anaesth. 2005;52(6):641–5.

    Article  PubMed  Google Scholar 

  6. Mishra S, Bhatnagar S, Jha RR, Singhal AK. Airway management of patients undergoing oral cancer surgery: a retrospective study. Eur J Anaesthesiol. 2005;22(7):510–4.

    Article  CAS  PubMed  Google Scholar 

  7. Stelea C, Pătrășcanu E, Cureniuc L, Hârtie LV, Comanescu MP, Crăcană A, et al. Airway management in head and neck cancer surgery. Roman J Oral Rehabil. 2020;12(4):5.

    Google Scholar 

  8. Walz JM, Zayaruzny M, Heard SO. Airway management in critical illness. Chest. 2007;131(2):608–20.

    Article  PubMed  Google Scholar 

  9. Mason RA, Fielder CP. The obstructed airway in head and neck surgery. Anaesthesia. 1999;54(7):625–8.

    Article  CAS  PubMed  Google Scholar 

  10. Benumof JL. Management of the difficult adult airway. With special emphasis on awake tracheal intubation. Anesthesiology. 1991;75(6):1087–110.

    Article  CAS  PubMed  Google Scholar 

  11. Johnston KD, Rai MR. Conscious sedation for awake fibreoptic intubation: a review of the literature. Can J Anaesth. 2013;60(6):584–99.

    Article  PubMed  Google Scholar 

  12. Varghese BT, Balakrishnan M, Kuriakose R. Fibre-optic intubation in oncological head and neck emergencies. J Laryngol Otol. 2005;119(8):634–8.

    Article  PubMed  Google Scholar 

  13. Morris IR. Fibreoptic intubation. Can J Anaesth. 1994;41(10):996–1007.

    Article  CAS  PubMed  Google Scholar 

  14. Wulf H, Brinkmann G, Rautenberg M. Management of the difficult airway. A case of failed fiberoptic intubation. Acta Anaesthesiol Scand. 1997;41(8):1080–2.

    Article  CAS  PubMed  Google Scholar 

  15. Bramwell KJ, Davis DP, Cardall TV, Yoshida E, Vilke GM, Rosen P. Use of the Trousseau dilator in cricothyrotomy. J Emerg Med. 1999;17(3):433–6.

    Article  CAS  PubMed  Google Scholar 

  16. McGrath BA, Bates L, Atkinson D, Moore JA, National Tracheostomy Safety Project. Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. Anaesthesia. 2012;67(9):1025–41.

    Article  CAS  PubMed  Google Scholar 

  17. Roh JL, Suh DC, Kim MR, Lee JH, Choi JW, Choi SH, et al. Endovascular management of carotid blowout syndrome in patients with head and neck cancers. Oral Oncol. 2008;44(9):844–50.

    Article  PubMed  Google Scholar 

  18. Tunkel DE, Anne S, Payne SC, Ishman SL, Rosenfeld RM, Abramson PJ, et al. Clinical practice guideline: nosebleed (epistaxis). Otolaryngol Head Neck Surg. 2020;162(1_suppl):S1–38.

    PubMed  Google Scholar 

  19. Corbridge RJ, Djazaeri B, Hellier WP, Hadley J. A prospective randomized controlled trial comparing the use of Merocel nasal tampons and BIPP in the control of acute epistaxis. Clin Otolaryngol Allied Sci. 1995;20(4):305–7.

    Article  CAS  PubMed  Google Scholar 

  20. Holland NJ, Sandhu GS, Ghufoor K, Frosh A. The Foley catheter in the management of epistaxis. Int J Clin Pract. 2001;55(1):14–5.

    Article  CAS  PubMed  Google Scholar 

  21. Alshehri WM, Alwehaibi WM, Ahmed MW, Albathi A, Alqahtani B. Merocel surgicel wrap technique to manage diffuse epistaxis in patients with comorbidities. Int J Otolaryngol. 2020;2020:8272914.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Smyth C, Hanna B, Scally C. Rapid rhino nasal packs: demonstration of depressurisation but not deflation. J Laryngol Otol. 2009;123(5):522–7.

    Article  CAS  PubMed  Google Scholar 

  23. Hiro-oki O, Kamiyama R, Takiguchi Y, Kimizuka K, Ishikawa N, Kishimoto S. Histopathological examination of ruptured carotid artery after irradiation. ORL J Otorhinolaryngol Relat Spec. 2002;64(3):226–8.

    Article  Google Scholar 

  24. Mazumdar A, Derdeyn CP, Holloway W, Moran CJ, Cross DT. Update on endovascular management of the carotid blowout syndrome. Neuroimaging Clin N Am. 2009;19(2):271–81.

    Article  PubMed  Google Scholar 

  25. Imai S, Kajihara Y, Kamei T, Komaki K, Tamada T, Shirai H, et al. Arterial embolization for control of bleeding in advanced head and neck malignancy. Int J Clin Oncol. 1998;3(4):228–32.

    Article  Google Scholar 

  26. Sittel C, Gossmann A, Jungehülsing M, Zähringer M. Superselective embolization as palliative treatment of recurrent hemorrhage in advanced carcinoma of the head and neck. Ann Otol Rhinol Laryngol. 2001;110(12):1126–8.

    Article  CAS  PubMed  Google Scholar 

  27. Kakizawa H, Toyota N, Naito A, Ito K. Endovascular therapy for management of oral hemorrhage in malignant head and neck tumors. Cardiovasc Intervent Radiol. 2005;28(6):722–9.

    Article  PubMed  Google Scholar 

  28. Mok JS, Marshall JN, Chan M, van Hasselt CA. Percutaneous embolization to control intractable epistaxis in nasopharyngeal carcinoma. Head Neck. 1999;21(3):211–6.

    Article  CAS  PubMed  Google Scholar 

  29. Remonda L, Schroth G, Caversaccio M, Lädrach K, Lövblad KO, Zbären P, et al. Endovascular treatment of acute and subacute hemorrhage in the head and neck. Arch Otolaryngol Head Neck Surg. 2000;126(10):1255–62.

    Article  CAS  PubMed  Google Scholar 

  30. Morrissey DD, Andersen PE, Nesbit GM, Barnwell SL, Everts EC, Cohen JI. Endovascular management of hemorrhage in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 1997;123(1):15–9.

    Article  CAS  PubMed  Google Scholar 

  31. Wilner HI, Lazo A, Metes JJ, Beil KA, Nowack P, Jacobs J. Embolization in cataclysmal hemorrhage caused by squamous cell carcinomas of the head and neck. Radiology. 1987;163(3):759–62.

    Article  CAS  PubMed  Google Scholar 

  32. Zimmerman RA, McLean G, Freiman D, Golestaneh Z, Perez M. The diagnostic and therapeutic role of angiography in lingual arterial bleeding. Radiology. 1979;133(3 Pt 1):639–43.

    Article  CAS  PubMed  Google Scholar 

  33. Earnest F, Forbes G, Sandok BA, Piepgras DG, Faust RJ, Ilstrup DM, et al. Complications of cerebral angiography: prospective assessment of risk. AJR Am J Roentgenol. 1984;142(2):247–53.

    Article  PubMed  Google Scholar 

  34. Greve J, Bas M, Schuler P, Turowski B, Scheckenbach K, Budach W, et al. Acute arterial hemorrhage following radiotherapy of oropharyngeal squamous cell carcinoma. Strahlenther Onkol Organ Dtsch Rontgengesellschaft Al. 2010;186(5):269–73.

    Article  Google Scholar 

  35. Risley J, Mann K, Jones NS. The role of embolisation in ENT: an update. J Laryngol Otol. 2012;126(3):228–35.

    Article  CAS  PubMed  Google Scholar 

  36. Jones JW, Reynolds M, Hewitt RL, Drapanas T. Tracheo-innominate artery erosion: successful surgical management of a devastating complication. Ann Surg. 1976;184(2):194–204.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Byard RW, Gilbert JD. Potentially lethal complications of tracheostomy: autopsy considerations. Am J Forensic Med Pathol. 2011;32(4):352–4.

    Article  PubMed  Google Scholar 

  38. Miyake N, Ueno H, Kitano H. Pathological consideration of tracheo-innominate artery fistula with a case report. Int J Pediatr Otorhinolaryngol. 2013;77(8):1322–4.

    Article  PubMed  Google Scholar 

  39. Epstein SK. Late complications of tracheostomy. Respir Care. 2005;50(4):542–9.

    PubMed  Google Scholar 

  40. Kuhn JG. Chemotherapy-associated hematopoietic toxicity. Am J Health Syst Pharm AJHP. 2002;59(15 Suppl 4):S4–7.

    Article  PubMed  Google Scholar 

  41. Estrera AS, Landay MJ, Grisham JM, Sinn DP, Platt MR. Descending necrotizing mediastinitis. Surg Gynecol Obstet. 1983;157(6):545–52.

    CAS  PubMed  Google Scholar 

  42. Beck HJ, Salassa JR, McCaffrey TV, Hermans PE. Life-threatening soft-tissue infections of the neck. Laryngoscope. 1984;94(3):354–62.

    Article  CAS  PubMed  Google Scholar 

  43. Chen MK, Wen YS, Chang CC, Huang MT, Hsiao HC. Predisposing factors of life-threatening deep neck infection: logistic regression analysis of 214 cases. J Otolaryngol. 1998;27(3):141–4.

    CAS  PubMed  Google Scholar 

  44. Mettias B, Robertson S, Buchanan MA. Retropharyngeal abscess after chemotherapy. BMJ Case Rep. 2018;2018:bcr-2017-222610.

    Article  PubMed  Google Scholar 

  45. Huang TT, Liu TC, Chen PR, Tseng FY, Yeh TH, Chen YS. Deep neck infection: analysis of 185 cases. Head Neck. 2004;26(10):854–60.

    Article  PubMed  Google Scholar 

  46. Bakir S, Tanriverdi MH, Gün R, Yorgancilar AE, Yildirim M, Tekbaş G, et al. Deep neck space infections: a retrospective review of 173 cases. Am J Otolaryngol. 2012;33(1):56–63.

    Article  PubMed  Google Scholar 

  47. Rolston KVI, Bodey GP. Factors responsible for increased susceptibility to infections. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei cancer medicine. 6th ed. Hamilton: BC Decker; 2003.

    Google Scholar 

  48. Magrini SM, Pasinetti N, Belgioia L, Triggiani L, Levis M, Ricardi U, et al. Applying radiation protection and safety in radiotherapy. Radiol Med (Torino). 2019;124(8):777–82.

    Article  PubMed  Google Scholar 

  49. Wang CP, Ko JY, Lou PJ. Deep neck infection as the main initial presentation of primary head and neck cancer. J Laryngol Otol. 2006;120(4):305–9.

    Article  PubMed  Google Scholar 

  50. Lin YY, Hsu CH, Lee JC, Wang HW, Lin YS, Wang CH, et al. Head and neck cancers manifested as deep neck infection. Eur Arch Otorhinolaryngol. 2012;269(2):585–90.

    Article  PubMed  Google Scholar 

  51. Daramola OO, Flanagan CE, Maisel RH, Odland RM. Diagnosis and treatment of deep neck space abscesses. Otolaryngol Head Neck Surg. 2009;141(1):123–30.

    Article  PubMed  Google Scholar 

  52. Wang LF, Tai CF, Kuo WR, Chien CY. Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg. 2010;39(4):335–41.

    PubMed  Google Scholar 

  53. Soon SR, Kanagalingam J, Johari S, Yuen HW. Head and neck cancers masquerading as deep neck abscesses. Singap Med J. 2012;53(12):840–2.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology and Otoneurosurgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

    A. Piccinini & G. P. Santoro

  2. University of Parma, Department of Medicine and Surgery, Department of Otorhinolaryngology and Otoneurosurgery, Parma, Italy

    M. Reale & E. Pasanisi

Authors
  1. A. Piccinini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Reale
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. P. Santoro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Pasanisi
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Emergency Surgery Dept., Parma University Hospital, Parma, Italy

    Antonio Tarasconi

  2. Oncology Dept., Parma University Hospital, Parma, Italy

    Simona Bui

  3. Digestive Surgery Dept, Ctr. Hosp. Univ. Grenoble Alpes, La Tronche, France

    Mircea Chirica

  4. Hepato-gastroenterology and Digestive oncology Dept., Grenoble-Alpes University Hospital, Grenoble, France

    Gaël Roth

  5. Department of Surgery, University of California, Irvine, Orange, CA, USA

    Jeffry Nahmias

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Piccinini, A., Reale, M., Santoro, G.P., Pasanisi, E. (2023). Emergency in Head and Neck Cancer Patients. In: Tarasconi, A., Bui, S., Chirica, M., Roth, G., Nahmias, J. (eds) Oncologic Surgical Emergencies. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-031-36860-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-36860-8_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36859-2

  • Online ISBN: 978-3-031-36860-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation