Department of Otolaryngology-Head and Neck Surgery and Audiology, Mayo Clinic, Jacksonville, FL 32224, USA.
Otolaryngol Head Neck Surg. 2010 Mar;142(3):351-4. doi: 10.1016/j.otohns.2009.11.028.
To identify major arteries in relationship to large pharyngeal tumors during transoral laser microsurgery.
Case series with planned data collection.
Mayo Clinic, Jacksonville, Florida.
We developed a new technique that combines three-dimensional CT angiography and enhanced soft-tissue neck CT for evaluation of pharyngeal tumors before transoral laser microsurgery. Data from CT angiography were used to create three-dimensional images of the tumor and adjacent arterial branches to better orient the surgeon to the spatial relationships of major arteries and pharyngeal tumors. Included were selected patients who had large tumors involving the pharynx and who underwent transoral laser microsurgery.
Eighteen patients were studied from June 2008 through January 2009. Tumor enhancement was absent or modest in four of 18 patients. Three of these four patients had superficial squamous cell carcinomas and one had adenoid cystic carcinoma. The remaining 14 patients had good tumor enhancement. The tumor involved the lingual artery in three and displaced the lingual or facial artery in two of these 14 patients. One anomalous right inferior thyroid artery was identified. Compared with routine enhanced soft-tissue neck CT, three-dimensional CT angiography greatly enhanced the anatomical relationships of the major arteries. In one patient, the surgeon's approach was changed after three-dimensional CT angiography demonstrated an encased lingual artery.
Three-dimensional CT angiography was useful in identifying the anatomical orientation of major arteries and the planning of transoral laser microsurgery to treat tumors involving the pharynx.
在经口激光微创手术中识别与大咽部肿瘤相关的主要动脉。
病例系列，计划收集数据。
佛罗里达州杰克逊维尔的梅奥诊所。
我们开发了一种新的技术，该技术结合了三维 CT 血管造影和增强型颈部软组织 CT，用于在经口激光微创手术前评估咽部肿瘤。来自 CT 血管造影的数据用于创建肿瘤和相邻动脉分支的三维图像，以便更好地为外科医生定向主要动脉和咽部肿瘤的空间关系。入选的患者为患有涉及咽部的大型肿瘤并接受经口激光微创手术的患者。
2008 年 6 月至 2009 年 1 月期间研究了 18 例患者。18 例患者中，4 例肿瘤增强不明显或适度。这 4 例患者中有 3 例为浅表鳞状细胞癌，1 例为腺样囊性癌。其余 14 例患者的肿瘤增强良好。在这 14 例患者中，肿瘤累及舌动脉，其中 2 例肿瘤将舌动脉或面动脉移位。发现了 1 例异常的右侧甲状腺下动脉。与常规增强型颈部软组织 CT 相比，三维 CT 血管造影大大增强了主要动脉的解剖关系。在 1 例患者中，三维 CT 血管造影显示舌动脉被包裹后，改变了外科医生的手术方法。
三维 CT 血管造影术有助于识别主要动脉的解剖方向，并计划经口激光微创手术治疗涉及咽部的肿瘤。
