Dorobisz Karolina, Dorobisz Tadeusz, Temporale Hanna, Zatoński Tomasz, Kubacka Marzena, Chabowski Mariusz, Dorobisz Andrzej, Kręcicki Tomasz, Janczak Dariusz
Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland.
Adv Clin Exp Med. 2016 Nov-Dec;25(6):1173-1177. doi: 10.17219/acem/61612.
Paragangliomas are rare neuroendocrine tumors, representing 0.03% of all tumors. Half of them develop in the head and neck, and among these 50% are sporadic cervical tumors.
The aim of the study was to carry out an epidemiological and clinical analysis of paraganglioma patients diagnosed and treated at the authors' clinics between 1985 and 2014.
The medical data of 47 patients were analyzed. All the patients were qualified for surgery. In 43 cases (88%), simple resection of the tumor was performed, including 11 cases (22%) that additionally required vascular suturing, and 5 (10%) that required reconstruction of the internal carotid artery. Carotid vessel repair was performed by shortening the internal carotid artery in 3 cases (6%), using a saphenous vein graft in 2 cases (4%), and by creating an anastomosis between the external carotid artery and the distal portion of the internal carotid artery in one case (2%).
In 40 cases (82%), the course of treatment was uneventful. Three patients (6%) were reoperated because of symptoms of cerebral stroke. Palsy of the hypoglossal nerve occurred in 3 cases (6%), and facial nerve palsy in 2 patients (4%). Six patients (12%) developed postoperative hematomas in the wound. In all the cases, histopathological examinations confirmed carotid paraganglioma.
Cooperation with an otolaryngologist and vascular surgeon during surgery is recommended due to frequent damage to carotid vessels by carotid paragangliomas. Detection of the tumor in the early stages improves surgical treatment outcomes and reduces the number of complications. Regular postoperative check-ups are necessary due to possible occurrences of multiple tumors.
副神经节瘤是罕见的神经内分泌肿瘤，占所有肿瘤的0.03%。其中一半发生在头颈部，在这些头颈部副神经节瘤中，50%是散发性颈部肿瘤。
本研究旨在对1985年至2014年间在作者所在诊所诊断和治疗的副神经节瘤患者进行流行病学和临床分析。
分析了47例患者的医疗数据。所有患者均符合手术条件。43例（88%）患者进行了肿瘤单纯切除术，其中11例（22%）还需要血管缝合，5例（10%）需要重建颈内动脉。3例（6%）通过缩短颈内动脉进行颈动脉血管修复，2例（4%）使用大隐静脉移植，1例（2%）通过在颈外动脉和颈内动脉远端之间建立吻合进行修复。
40例（82%）患者治疗过程顺利。3例（6%）患者因脑卒中症状接受了再次手术。3例（6%）患者发生舌下神经麻痹，2例（4%）患者发生面神经麻痹。6例（12%）患者伤口出现术后血肿。所有病例的组织病理学检查均证实为颈动脉副神经节瘤。
由于颈动脉副神经节瘤常损伤颈动脉血管，建议手术期间与耳鼻喉科医生和血管外科医生合作。早期发现肿瘤可改善手术治疗效果并减少并发症数量。由于可能出现多发肿瘤，术后定期检查是必要的。
