Venara-Vulpe I I, Morisod B, Morand G B, Zerlauth J-B, Simon C
Klinik für Otorhinolaryngologie, Hals- und Gesichtschirurgie, Universitätsspital Lausanne (CHUV), Bugnon 21, 1006, Lausanne, Schweiz.
Klinik für diagnostische und interventionelle Radiologie, Universitätsspital Lausanne (CHUV), Lausanne, Schweiz.
HNO. 2016 Dec;64(12):917-921. doi: 10.1007/s00106-016-0283-y.
Paragangliomas are highly vascularized usually benign neoplasms originating from the sympathoadrenal and parasympathetic paraganglia of the autonomic nervous system. When resectable, the management of these tumors consists of surgical ablation preceded by transarterial embolization. The aim of this article is to describe a novel treatment strategy combining intralesional percutaneous embolization with dissection using ultrasound scissors. The case of a 74-year-old women presenting with a Shamblin type III carotid body paraganglioma is presented. The combined approach of percutaneous embolization and ultrasound scissors permitted complete resection of the tumor with preservation of both the internal and external carotid artery, without postoperative cranial nerve deficits and with minimal blood loss. Preoperative intralesional embolization with a liquid embolic agent less than 24 h prior to surgical intervention in combination with ultrasound scissors appears to be an excellent strategy for surgical management of carotid body paragangliomas.
副神经节瘤是高度血管化的通常为良性的肿瘤,起源于自主神经系统的交感肾上腺和副交感神经节。当肿瘤可切除时,这些肿瘤的治疗包括在经动脉栓塞术之后进行手术切除。本文的目的是描述一种将瘤内经皮栓塞术与使用超声刀进行剥离相结合的新型治疗策略。本文介绍了一名74岁女性患有沙姆blin III型颈动脉体副神经节瘤的病例。经皮栓塞术和超声刀的联合方法使得肿瘤得以完全切除,同时保留了颈内动脉和颈外动脉,术后无颅神经缺损,且失血极少。在手术干预前不到24小时使用液体栓塞剂进行术前瘤内栓塞术并结合超声刀,似乎是颈动脉体副神经节瘤手术治疗的一种极佳策略。