Inan Hakki Caner, Yener Haydar Murat, Karaman Emin, Kizilkiliç Osman, Cansiz Harun, Eker Çağlar
Istanbul University Cerrahpasa Medical Faculty, Department of Otorhinolaryngology.
Istanbul University Cerrahpasa Medical Faculty, Department of Radiology, Istanbul, Turkey.
J Craniofac Surg. 2019 May/Jun;30(3):e267-e270. doi: 10.1097/SCS.0000000000005333.
In this study, we aimed to show the benefits of preoperative embolization on surgery of carotid body tumors.This is a retrospective study of the medical records of 20 patients who were operated for carotid body paragangliomas during 2011-2017. Computed tomography angiography (BTA) and/or magnetic resonance angiography (MRA) were performed for the entire patients. Patients were assessed according to the Shamblin classification. All patients were subjected to direct cerebral angiography by the femoral route 24 to 48 hours before the surgery and tumor embolization was performed in the appropriate cases (19 patients). The amount of hemorrhage and transfusion need during surgery has been reported. The ages of the patients ranged from 21 to 66, with an average of 45.65. In 20 patients ascendan pharyngeal artery was found as the main artery of tumor. No complications were seen after the embolization procedure. Tumor sizes ranged from 12 mm to 95 mm diameter (mean: 45, 5 mm). 10 patients (50%) were Shamblin type 1, 6 patients (30%) were Shamblin type 2, 4 patients (20%) were Shamblin type 3. In 5 patients (25%), the nerve (N. vagus or hypoglossus) was sacrificed due to cranial nerve involvement. Vagal and hypoglossal nerve sacrificed together in 4 patients.These patients' tumor sizes were bigger than 70 mm. Only in 1 patient, internal carotid artery injured and reconstructed with saphenous vein graft. Neurological deficit did not develop postoperatively. Bleeding was mean 275 mL (125 mL-700 mL). In conclusion, we believe that preoperative embolization of carotid paraganglioma is an effective procedure that helps surgeon during dissection with minimal blood loss. The embolization is relatively easy procedure without no additional complications.
在本研究中，我们旨在展示术前栓塞对颈动脉体瘤手术的益处。这是一项对2011年至2017年间接受颈动脉体副神经节瘤手术的患者病历进行的回顾性研究。对所有患者均进行了计算机断层血管造影（CTA）和/或磁共振血管造影（MRA）检查。根据沙姆布林分类法对患者进行评估。所有患者在手术前24至48小时经股动脉途径进行直接脑血管造影，并在适当病例（19例患者）中进行肿瘤栓塞。报告了手术期间的出血量和输血需求。患者年龄在21至66岁之间，平均年龄为45.65岁。20例患者中，咽升动脉被发现为肿瘤的主要供血动脉。栓塞术后未见并发症。肿瘤直径范围为12毫米至95毫米（平均：45.5毫米）。10例患者（50%）为沙姆布林1型，6例患者（30%）为沙姆布林2型，4例患者（20%）为沙姆布林3型。5例患者（25%）因脑神经受累而牺牲了神经（迷走神经或舌下神经）。4例患者同时牺牲了迷走神经和舌下神经。这些患者的肿瘤尺寸大于70毫米。仅1例患者颈内动脉受损，并用大隐静脉移植物进行了重建。术后未出现神经功能缺损。平均出血量为275毫升（125毫升至700毫升）。总之，我们认为颈动脉副神经节瘤的术前栓塞是一种有效的手术，有助于外科医生在手术解剖过程中减少失血。栓塞是一种相对简单的手术，没有额外的并发症。
