Abstract: PURPOSE: Outcomes of salvage surgery and carotid artery (CA) management were evaluated in patients with oral and oropharyngeal cancer. METHODS: Eighteen patients with recurrent oral and oropharyngeal squamous cell carcinoma involving CA underwent salvage surgery consisting of extended resection of the tumor, CA resection with and without reconstruction, and CA subadventitial dissection with and without encapsulation. Major tissue defects were reconstructed using composite flaps. RESULTS: One patient showed postoperative transient hemiplegia, and wound dehiscence occurred at the recipient site in 2 patients. Two patients developed carotid blowout. One patient who underwent CA resection and reconstruction suffered from carotid embolism. After 5-42 months of follow-up, 12 patients were disease-free, 2 alive with tumor, and 4 died of local recurrence or distant metastases. CONCLUSIONS: Salvage surgery remains an effective treatment modality. The affected carotid artery should be managed according to preoperative evaluation. Major defects can be reconstructed with a trapezius flap.

Key words: Salvage surgery, Oral cavity, Oropharynx, Squamous cell carcinoma, Recurrences, Carotid artery, Trapezius flap