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术前使用明胶海绵行上颌动脉栓塞术治疗鼻咽血管纤维瘤的疗效与安全性

Efficacy and safety of preoperative internal maxillary arterial embolization with gelfoam for nasopharyngeal angiofibroma.

作者信息

Pei Renguang, Yang Min, Wang Jian, Tong Xiaoqiang, Wang Guoxiang, Zou Yinghua

机构信息

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, 100034, People's Republic of China.

Department of Interventional Therapy, Yijishan Hospital of Wannan Medical College, Wuhu, People's Republic of China.

出版信息

Eur Arch Otorhinolaryngol. 2019 Mar;276(3):865-869. doi: 10.1007/s00405-018-05276-6. Epub 2019 Jan 3.

Abstract

PURPOSE

To investigate the efficacy and safety of preoperative internal maxillary arterial embolization with gelfoam particles in patients with nasopharyngeal angiofibroma.

MATERIALS AND METHODS

We retrospectively reviewed a total of 27 consecutive patients with pathologically confirmed nasopharyngeal angiofibroma from August 2006 to September 2018. Of the 27 enrolled patients, 10 patients received surgical excision alone; 17 patients received preoperative internal maxillary arterial embolization followed by surgical excision. Embolic agents were gelfoam particles.

RESULTS

The mean volume of intro-operative blood loss was 385.3 ml in patients with preoperative arterial embolization, which was significantly lower than 1215.0 ml in the patients without preoperative arterial embolization (P < 0.001). The mean surgical time was shorter in patients with preoperative arterial embolization than in the patient without preoperative arterial embolization, but the difference had no statistical significance (205.0 vs 264.5 min, P = 0.064). Neurological complications such as facial palsy or vision loss or hemiplegia were not observed in patients with preoperative arterial embolization.

CONCLUSION

Internal maxillary artery embolization with gelfoam particles suffices to provide an effective and safe adjuvant procedure for surgical excision of nasopharyngeal angiofibroma.

摘要

目的

探讨术前经上颌内动脉用明胶海绵颗粒栓塞术治疗鼻咽血管纤维瘤的有效性和安全性。

材料与方法

回顾性分析2006年8月至2018年9月期间连续收治的27例经病理证实的鼻咽血管纤维瘤患者。27例入选患者中,10例仅接受手术切除;17例接受术前经上颌内动脉栓塞术,随后进行手术切除。栓塞剂为明胶海绵颗粒。

结果

术前动脉栓塞患者术中平均失血量为385.3ml,显著低于未进行术前动脉栓塞患者的1215.0ml(P<0.001)。术前动脉栓塞患者的平均手术时间短于未进行术前动脉栓塞的患者,但差异无统计学意义(205.0对264.5分钟,P = 0.064)。术前动脉栓塞患者未观察到面神经麻痹、视力丧失或偏瘫等神经并发症。

结论

经上颌内动脉用明胶海绵颗粒栓塞术足以作为鼻咽血管纤维瘤手术切除的一种有效且安全的辅助治疗方法。

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