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C类鼓室颈静脉球瘤中颈骨岩部颈内动脉的处理

Management of the cervico-petrous internal carotid artery in class C tympanojugular paragangliomas.

作者信息

Bacciu Andrea, Prasad Sampath Chandra, Sist Natalie, Rossi Giulia, Piazza Paolo, Sanna Mario

机构信息

Department of Clinical and Experimental Medicine, Otolaryngology Unit, University-Hospital of Parma, Parma, Italy.

Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy.

出版信息

Head Neck. 2016 Jun;38(6):899-905. doi: 10.1002/hed.24284. Epub 2015 Nov 28.

Abstract

BACKGROUND

Management of the cervical and petrous internal carotid artery (ICA) is frequently required in Fisch class C tympanojugular paragangliomas (TJPs). The purpose of this study was to discuss the perioperative intervention of the ICA in patients who underwent surgical resection of a TJP.

METHODS

A retrospective study of 237 patients surgically treated for Fisch class C TJPs was done to identify cases that required ICA management.

RESULTS

Management of the ICA was required in 176 patients (74.2%). Forty-two patients required just an ICA decompression, 88 underwent a subperiosteal dissection, 19 underwent subadventitial dissection without intraluminal stenting, 17 underwent subadventitial dissection with intraluminal stenting, and 12 underwent arterial resection after permanent balloon occlusion. There were no complications associated with the endovascular procedures. Gross total tumor resection was achieved in 91.5% of the cases.

CONCLUSION

Preoperative endovascular intervention, in selected cases, facilitates gross total tumor removal and significantly reduces the risk of an intraoperative ICA injury. © 2015 Wiley Periodicals, Inc. Head Neck 38: 899-905, 2016.

摘要

背景

在费施C级颈静脉鼓室副神经节瘤(TJPs)的治疗中,颈段和岩骨段颈内动脉(ICA)的处理经常是必要的。本研究的目的是探讨接受TJP手术切除患者的ICA围手术期干预措施。

方法

对237例接受费施C级TJPs手术治疗的患者进行回顾性研究,以确定需要处理ICA的病例。

结果

176例患者(74.2%)需要处理ICA。42例患者仅需进行ICA减压;88例进行了骨膜下剥离;19例进行了外膜下剥离但未进行腔内支架置入;17例进行了外膜下剥离并置入腔内支架;12例在永久性球囊闭塞后进行了动脉切除。血管内操作无并发症发生。91.5%的病例实现了肿瘤全切。

结论

在特定病例中,术前血管内干预有助于实现肿瘤全切,并显著降低术中ICA损伤风险。© 2015威利期刊公司。《头颈》38: 899 - 905,2016年。

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