Kraus D H, Sterman B M, Hakaim A G, Beven E G, Levine H L, Wood B G, Tucker H M
Department of Otolaryngology, Cleveland Clinic Foundation, OH 44195-5034.
Arch Otolaryngol Head Neck Surg. 1990 Dec;116(12):1384-7. doi: 10.1001/archotol.1990.01870120030003.
The surgical management of carotid body tumors requires identification and preservation of neural and vascular structures without compromising resection of the neoplasm. Fifteen patients were examined and treated for carotid body tumors at the Cleveland (Ohio) Clinic Foundation from 1979 through 1987. The benchmark of diagnosis is bilateral carotid angiography. When neural structures are free of tumor, meticulous dissection facilitates their preservation. Large tumor size increases risk for arterial resection necessitating reconstruction. The use of a vascular shunt minimizes the risk of cerebral ischemia. Postoperative intravenous digital subtraction angiography allows for evaluation of arterial repair. A retrospective review of 15 carotid body tumor resections performed in 14 patients revealed no evidence of tumor recurrence, no mortality associated with surgical intervention, no postoperative cerebrovascular accident, and limited morbidity associated with unavoidable sacrifice of neural elements.
颈动脉体瘤的外科治疗需要在不影响肿瘤切除的情况下识别并保留神经和血管结构。1979年至1987年期间,有15例患者在俄亥俄州克利夫兰诊所基金会接受了颈动脉体瘤的检查和治疗。诊断的基准是双侧颈动脉血管造影。当神经结构未受肿瘤侵犯时,细致的解剖有助于保留这些结构。肿瘤体积较大增加了动脉切除并需要重建的风险。使用血管分流器可将脑缺血的风险降至最低。术后静脉数字减影血管造影可用于评估动脉修复情况。对14例患者进行的15例颈动脉体瘤切除术的回顾性研究显示,没有肿瘤复发的迹象,没有与手术干预相关的死亡病例,没有术后脑血管意外,并且与不可避免地牺牲神经元件相关的发病率有限。