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应用改良手术技术后,比较颈静脉球部副神经节瘤早期和晚期病例的手术效果。

Comparison of surgical outcomes between early and advanced class of jugular paragangliomas following application of our modified surgical techniques.

机构信息

Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, 200031, China.

Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, 200031, China.

出版信息

Sci Rep. 2023 Jan 17;13(1):885. doi: 10.1038/s41598-023-27821-y.

Abstract

To compare the safety and effectiveness of surgical treatment of jugular paragangliomas (JPs) following the application of our modified surgical techniques. Fifty-six patients with JPs were analyzed for tumor classification, surgical outcomes, and intratumor blood vessels. The gross total resection in C1-2 (100%) was significantly greater than that in C3 and D (66.7%). Good postoperative facial nerve (FN) function (House-Brackmann I-II) was achieved in 89.5% C1-2 cases, which was not significantly different from C3 and D (93.3%) (P = 0.694). Preoperative and postoperative lower cranial nerve (LCN) deficits correlated with the Fisch's classification of tumors (P < 0.05), and intraoperative blood loss was greater in advanced tumors (P = 0.050). Further study showed that the cross-sectional area of intratumor blood vessels was positively associated with intraoperative blood loss (P < 0.001). Surgical excision of JPs is a safe and effective strategy, and early surgical treatment is a good option for patients with C1-2 tumors without surgical contraindications.

摘要

目的

比较应用改良手术技术后治疗颈静脉球瘤(JPs)的安全性和有效性。

方法

分析 56 例 JPs 患者的肿瘤分类、手术结果和肿瘤内血管。C1-2 区的全切除率(100%)明显高于 C3 和 D 区(66.7%)。C1-2 区术后面神经(FN)功能良好(House-Brackmann I-II)的比例为 89.5%,与 C3 和 D 区无显著差异(93.3%)(P=0.694)。术前和术后颅神经(LCN)损伤与 Fisch 肿瘤分类相关(P<0.05),高级别肿瘤术中出血量更大(P=0.050)。进一步研究表明,肿瘤内血管的横截面积与术中出血量呈正相关(P<0.001)。

结论

手术切除 JPs 是一种安全有效的策略,对于无手术禁忌证的 C1-2 期肿瘤患者,早期手术治疗是一个较好的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4247/9845292/202c1cb7a2da/41598_2023_27821_Fig1_HTML.jpg

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