Mukherjee P, Huilgol R, Graham A, Fagan P
Department of Surgery,University of Sydney,Sydney,Australia.
Department of Vascular Surgery,St Vincent's Hospital,Sydney,Australia.
J Laryngol Otol. 2016 Jul;130 Suppl 4:S29-34. doi: 10.1017/S0022215116000694.
Three cases of internal carotid artery aneurysm affecting the distal cervical segment were retrospectively reviewed.
Two patients underwent open surgical repair requiring petrous segment exposure for bypass of the affected segment using a Fisch type A lateral skull base approach. The third patient underwent endovascular stenting.
There were no cerebrovascular complications post-operatively. Both open repair patients experienced temporary lower cranial nerve palsies. One required facial nerve grafting. All patients had patent grafts at follow up. The stent graft patient had a small endoleak at six months.
Endovascular and open approaches both have advantages and disadvantages. Treatment needs to be tailored to the lesion and the patient. An open surgical approach is difficult but well established. Endovascular treatment of these lesions is a relatively recent technique, and new cases need to be continually reported with a view to attaining long-term data.
回顾性分析3例累及颈段远端的颈内动脉动脉瘤病例。
2例患者接受了开放手术修复，采用Fisch A型侧颅底入路暴露岩骨段，以便对病变段进行搭桥。第3例患者接受了血管内支架置入术。
术后无脑血管并发症。2例接受开放修复的患者均出现暂时性低位颅神经麻痹。其中1例需要进行面神经移植。所有患者随访时移植血管均通畅。支架植入患者在6个月时出现小的内漏。
血管内治疗和开放手术各有优缺点。治疗需要根据病变情况和患者个体进行调整。开放手术难度大但技术成熟。对这些病变进行血管内治疗是一项相对较新的技术，需要持续报告新病例以获取长期数据。
