Synchronous Management of Incidental Neck Masses and Carotid Artery Disease

Abstract

Incidental identification of neck masses is not uncommon during the workup and management of surgically treatable carotid artery stenosis. Retrospective chart review was made over a 12-month period of all patients who underwent carotid endarterectomy. Twelve patients with incidental neck masses were identified among 227 subjects. Of these 12 patients, three presented with clinically palpable submandibular gland enlargements, eight had sonographic evidence of incidental thyroid nodules, and one patient had significant enlargement of cervical lymph nodes excised at the time of carotid surgery. The last patient was found to have a metastatic squamous cell carcinoma originating from the pyriform sinus. Eleven of twelve patients had successful excisions of the neck mass synchronous with carotid endarterectomy. The postoperative course was uneventful in these 11 patients, but one required postoperative hematoma drainage. All patients were discharged with a length of stay less than 1.5 days. Incidental neck masses are not uncommon. When detected, these can be managed synchronously with carotid endarterectomy demonstrating no significant change in outcome.

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