Li Meng-Qi, Zhao Yan, Sun Huai-Yu, Yang Xin-Yu
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Neurosurgery, TieMei General Hospital of Liaoning Health Company Affiliated Shenyang Medical College, Tieling 112000, Liaoning Province, China.
World J Clin Cases. 2019 Aug 26;7(16):2346-2351. doi: 10.12998/wjcc.v7.i16.2346.
Surgical treatment for large carotid body tumor (CBT), particularly the Shamblin III type, is challenging and rarely reported.
In July 2014, a 63-year-old woman presented to our hospital with a large CBT (130 mm × 60 mm × 70 mm). The lesion was hypervascular, spanned from the first to the seventh cervical vertebra, and adhered to the right common carotid artery (CCA), internal carotid artery (ICA) and external carotid artery (ECA). The resection was carried out in a hybrid operating theatre. First, we used Onyx gel to embolize the feeding artery. An ICA balloon was used to prevent gel entry into the ICA. After shrinkage and hardening of the CBT, we quickly resected the CBT as well as a part of the ECA that adhered to the CBT. A vascular shunt was inserted between CCA and ICA, and the part where the ICA was cut off from the CCA was directly sutured. A follow-up at four years later showed no neurological damage.
For large hypervascular CBT, embolization of the feeding artery prior to resection is helpful. The hybrid operating theatre is the ideal platform to carry out such operations.
大型颈动脉体瘤(CBT)的手术治疗,尤其是Shamblin III型,具有挑战性且鲜有报道。
2014年7月,一名63岁女性因大型CBT(130 mm×60 mm×70 mm)就诊于我院。该病变血管丰富,跨越第一至第七颈椎,与右侧颈总动脉(CCA)、颈内动脉(ICA)和颈外动脉(ECA)粘连。手术在杂交手术室进行。首先,我们使用Onyx胶栓塞供血动脉。使用ICA球囊防止胶进入ICA。CBT缩小变硬后,我们迅速切除CBT以及与CBT粘连的部分ECA。在CCA和ICA之间插入血管分流器,将ICA从CCA切断的部分直接缝合。四年后的随访显示无神经损伤。
对于大型富血管CBT,术前栓塞供血动脉是有帮助的。杂交手术室是进行此类手术的理想平台。