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钝性剥离后颈动脉体瘤和假性动脉瘤的处理

Management of carotid body tumor and pseudoaneurysm after blunt dissection.

作者信息

Chen Wei-liang, Xu Lin-feng, Tang Qiong-lan, Zhang Da-ming

机构信息

From the *Departments of Oral and Maxillofacial Surgery, †Interventional Radiology, and ‡Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Craniofac Surg. 2015 Mar;26(2):477-80. doi: 10.1097/SCS.0000000000001466.

Abstract

BACKGROUND

Surgical treatment of carotid body tumors remains challenging, and this study evaluated the outcomes of carotid body tumor and pseudoaneurysm after blunt dissection of the tumors.

METHODS

Six cases were classified as Shamblin groups I, II, and III (1, 1, and 4 cases, respectively). Tumor size ranged from 2 × 3 to 5 × 6 (median, 3.7 × 4.7) cm. Two patients underwent blunt dissection of the carotid body tumor, two underwent blunt dissection and ligation of the external carotid artery of the carotid body tumor, and two patients had common carotid artery-internal carotid artery artificial vascular reconstruction.

RESULTS

No perioperative mortality or stroke occurred. The mean blood loss was 455 (range, 250-650) mL. Two patients had pseudoaneurysm or vocal cord paralysis postoperatively and recovered with stent graft implantation and medical treatment, respectively. The patients were followed for 6 to 17 (mean, 11) months, with no recurrence observed.

CONCLUSION

Surgical treatment of a carotid body tumor is acceptably safe and effective according to Shamblin classification. Pseudoaneurysm can occur after blunt dissection of the tumor and can be treated with a stent graft.

摘要

背景

颈动脉体瘤的外科治疗仍然具有挑战性,本研究评估了钝性剥离肿瘤后颈动脉体瘤及假性动脉瘤的治疗效果。

方法

6例患者分别分为沙姆林I、II和III型(分别为1例、1例和4例)。肿瘤大小为2×3至5×6(中位数为3.7×4.7)厘米。2例患者接受了颈动脉体瘤钝性剥离,2例接受了颈动脉体瘤钝性剥离并结扎颈外动脉,2例患者进行了颈总动脉-颈内动脉人工血管重建。

结果

围手术期无死亡或卒中发生。平均失血量为455(范围250 - 650)毫升。2例患者术后出现假性动脉瘤或声带麻痹,分别通过植入覆膜支架和药物治疗后康复。患者随访6至17(平均11)个月,未观察到复发。

结论

根据沙姆林分类,颈动脉体瘤的外科治疗具有可接受的安全性和有效性。肿瘤钝性剥离后可能发生假性动脉瘤,可采用覆膜支架治疗。

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