Zanaret M, Gras R, Legre R, Kretman B, Cannoni M, Pech A
Département d'ORL, CHU Timone, Marseille.
Ann Otolaryngol Chir Cervicofac. 1990;107(8):559-63.
The authors report a case of voluminous cervicofacial angioma with pelvi-lingual extension which had undergone multiple operations and had embolized. The exeresis consisted of cutaneous sacrifice of 10 x 10 cm combined with a longitudinal hemi-pelvi-glossectomy. Two pediculated musculocutaneous strips of greater pectoris and greater dorsal muscle were associated for reconstruction. The operation took place under extracorporeal circulation by femoral cannulation and deep hypothermia. Post-operative recovery was simple, with resumption of normal phonation and eating. No recurrence was observed upon arteriographic control at six months. The use of extracorporeal circulation is exceptional outside cardiac problems (low tracheal stenosis, intracranial aneurysm). The authors suggest the value of this technique for the treatment of angiomas purportedly inoperable because of the risk of major blood loss.
作者报告了一例巨大的颈面部血管瘤,已延伸至盆腔及舌部,此前已接受多次手术并进行了栓塞治疗。切除范围包括牺牲10×10cm的皮肤,并联合纵向半侧盆腔舌切除术。使用两条带蒂的胸大肌和背阔肌肌皮瓣进行重建。手术在体外循环下通过股动脉插管和深度低温进行。术后恢复顺利,语音和进食功能恢复正常。术后6个月血管造影检查未发现复发。体外循环在心脏问题(如低位气管狭窄、颅内动脉瘤)之外的应用非常罕见。作者认为该技术对于治疗因大出血风险而据称无法手术的血管瘤具有价值。