Rupture of supra-aortic neck arteries due to lesions caused by tracheal tubes.

Haemorrhages from the common carotid or innominate artery caused by tracheal tubes are rare but dramatic complications of head and neck surgery. Patients with metal tracheostomy cannulas or patients in the phase of wound healing after radical tumour resections of the pharynx and larynx run a greater risk. Following extensive tumour resections and radiation of the upper respiratory and digestive tracts in 680 patients, acute bleeding of the larger neck arteries occurred in 18 patients. In four of these cases, fistulae developed in the innominate or common carotid artery. These ruptures were caused by both plastic and metal tracheal tubes.