Wang J J, Liu S X, Yu D Z, Zhu Y Q, Zhang W T, Chen Z N, Yin S K
Department of Otolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Hearing Test Center, Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai Oriental Institute of Otorhinolaryngology, Shanghai 200233, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jul 7;57(7):835-842. doi: 10.3760/cma.j.cn115330-20210707-00434.
To report the experience of the application of internal carotid artery stent in skull base surgery, and to clarify the important role of internal carotid artery stent in skull base surgery. A retrospective study of 22 cases with skull base neoplasms implanted with internal carotid artery stents in the Department of ENT Head and Neck Surgery at the Sixth People's Hospital affiliated with Shanghai Jiao Tong University between July 2019 and January 2021 was conducted. Among them, 17 were male and 5 were female, aged between 33 and 75 years. There were 5 cases on the left, 16 cases on the right, and 1 case on both sides. Of these, there were 4 cases of jugular paraganglioma, 1 case of chondrosarcoma in the jugular foramen, 1 case of carotid body paraganglioma, and 16 cases of nasopharyngeal carcinoma after radiotherapy. The degree of internal carotid artery erosion was assessed by computed tomography angiography (CTA), magnetic resonance imaging and digital subtraction angiography (DSA) images in 22 patients before surgery. It was found that the internal carotid artery was involved to varying degrees in all patients, so internal carotid artery stents were implanted before surgery. Tumor tissue was found to surround the internal carotid artery to varying degrees. Total or subtotal tumor resection was performed in all patients, and no intraoperative and postoperative complications occurred. The postoperative follow-up was 5 months to 2 years, and all patients had no complications such as spontaneous bleeding and pseudo aneurysm. There were no signs of stenosis or occlusion of the internal carotid artery stent segment in all cases. For patients with skull base tumors, preoperative imaging indicates the limited involvement of the internal carotid artery, and internal carotid artery stent implantation before surgery is a safe and effective treatment.
报告颈内动脉支架在颅底手术中的应用经验，阐明颈内动脉支架在颅底手术中的重要作用。对2019年7月至2021年1月在上海交通大学附属第六人民医院耳鼻咽喉头颈外科植入颈内动脉支架的22例颅底肿瘤患者进行回顾性研究。其中男性17例，女性5例，年龄33至75岁。左侧5例，右侧16例，双侧1例。其中，颈静脉球副神经节瘤4例，颈静脉孔软骨肉瘤1例，颈动脉体副神经节瘤1例，放疗后鼻咽癌16例。术前通过计算机断层血管造影（CTA）、磁共振成像和数字减影血管造影（DSA）图像对22例患者的颈内动脉侵蚀程度进行评估。发现所有患者的颈内动脉均有不同程度受累，因此术前均植入颈内动脉支架。发现肿瘤组织不同程度地包绕颈内动脉。所有患者均行肿瘤全切除或次全切除，术中及术后均未发生并发症。术后随访5个月至2年，所有患者均未出现自发性出血和假性动脉瘤等并发症。所有病例颈内动脉支架段均无狭窄或闭塞迹象。对于颅底肿瘤患者，术前影像学提示颈内动脉受累局限，术前植入颈内动脉支架是一种安全有效的治疗方法。
