Lai Yen-Shuo, Tseng Wan-Ling, Pan Shin-Chen
From the Department of Surgery, Section of Plastic and Reconstructive Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Ann Plast Surg. 2021 Feb 1;86(2S Suppl 1):S119-S122. doi: 10.1097/SAP.0000000000002623.
Carotid body paragangliomas are rare and therapeutically challenging. Shamblin I or II carotid body paraganglioma can be removed en bloc. This operation is sometimes combined with preoperative transarterial embolization to control bleeding. However, Shamblin III carotid body paraganglioma, which is encased with carotid vessels, is difficult to remove without carotid artery ligation for excision. Sometimes, not all tumor tissues are removed during operation and residual tumor tissues remain. Here, we review a case of Shamblin III carotid body paraganglioma removal without preoperative transarterial embolization or ligation of the carotid artery. We present a successful technique for Shamblin III carotid body paraganglioma resection that reduces bleeding during the operation.
A 74-year-old male patient who had an enlarged left neck mass for more than 20 years underwent tumor excision. The final pathology was carotid body paraganglioma. During the operation, the tumor was discovered to be encased in the bifurcation of the common carotid artery. We carefully isolated and temporarily clamped the common carotid artery to enable application of the finger dissection method to completely free the tumor from the carotid artery in a safe and bloodless plane.
Neither intraoperative massive bleeding nor postoperative cranial nerve deficit occurred. Favorable wound status was noted during outpatient department follow-up.
We describe a successful case of Shamblin III carotid body paraganglioma removal using temporary clamping of the common carotid artery and the finger dissection method.
颈动脉体副神经节瘤罕见且治疗具有挑战性。Shamblin I型或II型颈动脉体副神经节瘤可整块切除。该手术有时会结合术前经动脉栓塞以控制出血。然而，Shamblin III型颈动脉体副神经节瘤被颈动脉血管包绕，若不结扎颈动脉则难以切除。有时，手术中并非所有肿瘤组织都能被切除，会残留肿瘤组织。在此，我们回顾一例未进行术前经动脉栓塞或颈动脉结扎而切除Shamblin III型颈动脉体副神经节瘤的病例。我们展示了一种成功的Shamblin III型颈动脉体副神经节瘤切除术技术，可减少手术中的出血。
一名74岁男性患者，左颈部肿块增大20余年，接受了肿瘤切除手术。最终病理结果为颈动脉体副神经节瘤。手术中发现肿瘤被包绕在颈总动脉分叉处。我们小心地分离并临时夹闭颈总动脉，以便应用手指分离法在安全且无血的平面将肿瘤与颈动脉完全分离。
术中未发生大量出血，术后也未出现颅神经功能缺损。门诊随访时伤口状况良好。
我们描述了一例通过临时夹闭颈总动脉并采用手指分离法成功切除Shamblin III型颈动脉体副神经节瘤的病例。
