Abstract:Objective To investigate the causes, emergency management of internal carotid artery rupture and hemorrhage in endoscopic transnasal salvage operation for recurrent nasopharyngeal carcinoma. Methods The clinical data of 2 patients with internal carotid artery rupture during the operation of recurrent nasopharyngeal carcinoma from March 2020 to February 2021 in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University were analyzed retrospectively. Two patients underwent electromagnetic navigation assisted endoscopic transnasal nasopharyngeal carcinoma surgery. After internal carotid artery rupture and bleeding, the two patients were treated with iodoform gauze for hemostasis during operation, and emergency internal carotid artery embolization was performed. Postoperative anti-infection, anticoagulation and symptomatic supportive treatment were given. Results After treatment, the patients were in a stable condition with no associated complications. Conclusion In patients with intermediate or advanced recurrent nasopharyngeal carcinoma, if the tumor is adjacent, invasive or circumventing the internal carotid artery, the status and compensation of the internal carotid artery should be fully assessed before surgery. Once internal carotid artery rupture and bleeding occurs during surgery, iodoform gauze filling and compression hemostasis should be performed immediately and emergency interventional treatment should be performed, which can save the patient's life and reduce the occurrence of complications such as cerebral infarction.