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头颈部副神经节瘤:一家三级医疗中心的十年经验。一项队列研究。

Head and neck paragangliomas: Ten years of experience in a third health center. A cohort study.

作者信息

Merzouqi Boutaina, El Bouhmadi Khadija, Oukesou Youssef, Rouadi Sami, Abada Redallah Larbi, Roubal Mohamed, Mahtar Mohamed

机构信息

Otorhinolaryngology and Head and Neck Surgery Department, 20 August 1953 Hospital, Casablanca, Morocco.

出版信息

Ann Med Surg (Lond). 2021 May 20;66:102412. doi: 10.1016/j.amsu.2021.102412. eCollection 2021 Jun.

Abstract

Head and neck paragangliomas are rare vascular tumors derived from the paraganglionic system, located at the carotid body, jugular vein, tympanic cavity and vagal nerve. From 2010 to 2020, a cohort of 26 patients divided in two groups, 15 with cervical paragangliomas and 11 with temporal bone paragangliomas, was reviewed by analysing the medical history, the epidemiological and clinical parameters, the imaging results and classification, the modality of treatment and outcome. Cervical paragangliomas present as firm and pulsatile mass with the characteristic aspect of "salt and pepper" on MRI T1 weighted sequences. The most common type on Shamblin classification was the type II. Total surgical resection was performed in 93,33% of cases. The sensitivity of MRI in the diagnosis of vagal paragangliomas was up to 75%, with a specificity of 90,91% and the correlation of the MRI results and the findings of surgical exploration is significant with p ⩽ 0.02. Temporal bone paragangliomas appear as pulsatile mass behind the tympanic membrane, causing variable hearing loss in 90,90% of the cases. The facial nerve is the most frequently affected cranial nerve, in 36,36% of the cases. The main type according to FISH classification is the type B. Embolization was performed in all type C tumors. Surgery was the first line treatment while the inoperable patients were considered for radiotherapy. The aim of this study is to report the main clinical features of head and neck paragangliomas, the imaging tools and findings evaluating their sensitivity and specificity and the treatment protocol and outcome.

摘要

头颈部副神经节瘤是起源于副神经节系统的罕见血管性肿瘤,位于颈动脉体、颈静脉、鼓室和迷走神经。2010年至2020年,对一组26例患者进行了回顾性分析,这些患者分为两组,15例为颈部副神经节瘤,11例为颞骨副神经节瘤,分析内容包括病史、流行病学和临床参数、影像学结果及分类、治疗方式和预后。颈部副神经节瘤表现为质地坚硬且有搏动的肿块,在MRI T1加权序列上具有“椒盐”样特征。Shamblin分类中最常见的类型是II型。93.33%的病例进行了手术全切。MRI诊断迷走神经副神经节瘤的敏感性高达75%,特异性为90.91%,MRI结果与手术探查结果的相关性显著,p≤0.02。颞骨副神经节瘤表现为鼓膜后有搏动的肿块,90.90%的病例导致不同程度的听力损失。面神经是最常受累的颅神经,占病例的36.36%。根据FISH分类,主要类型是B型。所有C型肿瘤均进行了栓塞治疗。手术是一线治疗方法,而无法手术的患者则考虑进行放疗。本研究的目的是报告头颈部副神经节瘤的主要临床特征、评估其敏感性和特异性的影像学工具及结果,以及治疗方案和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/8166645/dc2cac35df9d/gr1.jpg

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