CC-BY-NC-ND 4.0 · J Neurol Surg Rep 2017; 78(04): e125-e128
DOI: 10.1055/s-0037-1608635
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Endonasal Repair of Internal Carotid Artery Injury during Endoscopic Endonasal Surgery

Irit Duek1, 2, Gill E. Sviri3, Moran Amit1, 2, Ziv Gil1, 2
  • 1Department of Otolaryngology Head and Neck Surgery, The Head and Neck Center, Rambam Health Care Campus, Haifa, Israel
  • 2The Laboratory for Applied Cancer Research, Clinical Research Institute, Rambam Health Care Campus, Technion – Israel Institute of Technology, Haifa, Israel
  • 3Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
Further Information

Publication History

18 February 2017

20 September 2017

Publication Date:
10 November 2017 (online)


Background Injury to the cavernous portion of the internal carotid artery (ICA) during endoscopic skull base surgery is a well-recognized rare complication that can be associated with high rates of morbidity and mortality. Many techniques have been suggested to manage ICA injury with varying degrees of success.

Objectives We provide a detailed technical description of an operative technique for endoscopic management of carotid artery injury.

Methods A case of ICA injury during endoscopic skull base surgery is presented. The immediate treatment measurements include: (1) early recognition of ICA injury, (2) briefing of the team and preparations, (3) packing, (4) harvesting of temporalis muscle patch, (5) placement of the muscle patch over the defect, and (6) gentle compression for 10 minutes.

Results The technique facilitates quick repair and restores normal blood flow through the damaged artery. Exsanguination or the symptoms of stroke that may occur from prolonged occlusion of the ICA are therefore prevented.

Conclusion The proposed protocol is useful for the management of a potentially life-threatening ICA injury.


This is an original article reviewed by all the authors and not under consideration for publication elsewhere.