Carotid Blowout Syndrome in Head and Neck Cancer Patients: Management of Patients At Risk for CBS

Allison A. Slijepcevic, Joseph Roh, Patrik Pipkorn, Kim Lipsey, Joseph P. Bradley

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objectives: Carotid blowout syndrome (CBS) is an acute, rare life-threatening hemorrhage that occurs in patients with a history of head and neck cancer and radiation therapy. The primary objective of this review was to identify risk factors and assess treatment and survival outcomes following CBS. Methods: A systematic review of published literature was performed. Information including risk factors, treatment, and outcomes of CBS were collected. Results: A total of 49 articles and 2220 patients were included in the systematic review. Risk factors for developing CBS included a history of radiation therapy, wound complications, and advanced tumor stage. The initial management of CBS included establishing a stable airway, gaining hemostasis, and repletion of blood loss. Endovascular and surgical procedures treat CBS with infrequent rates of rebleeding and periprocedural complications. Short-term survival following treatment of CBS shows high survival rates when considering CBS-related complications and underlying disease, however, long-term survival related to the underlying disease demonstrated high mortality. Conclusions: Identifying patients at risk for CBS enables practitioners to counsel patients on life-saving interventions and expected outcomes following treatment of CBS. Treatment of CBS is associated with high short-term survival, although long-term survival related to underlying disease is low. Level of Evidence: N/A Laryngoscope, 133:576–587, 2023.

Original languageEnglish
Pages (from-to)576-587
Number of pages12
Issue number3
StatePublished - Mar 2023


  • CBS
  • carotid blowout
  • carotid blowout syndrome
  • head and neck cancer
  • radiation therapy


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