Urken M L, Biller H F, Haimov M
Laryngoscope. 1985 Dec;95(12):1472-7. doi: 10.1288/00005537-198512000-00007.
Tumors of the skull base with carotid artery involvement have heretofore required carotid ligation or been deemed inoperable. Two case reports are presented in which en bloc resection of malignant base of skull tumors included removal of a portion of the internal carotid artery. In the first case, the tumor was primarily in the parapharyngeal space and extended to the base of skull. Partial temporal bone resection was carried out to obtain exposure for carotid reconstruction. The second case involved an en bloc temporal bone resection for a recurrent, malignant, mixed tumor that had invaded the carotid canal. Revascularization was achieved in both cases by an autogenous, saphenous vein graft. The patients suffered no postoperative ischemic neurologic sequelae. These are the first known cases of a carotid bypass with distal anastomosis to the intratemporal portion of the internal carotid artery for a malignant base of skull neoplasm. The authors propose this procedure as an alternative to carotid ligation during surgery of tumors of the skull base requiring carotid resection.
累及颈动脉的颅底肿瘤以往需要进行颈动脉结扎术，或被认为无法手术切除。本文报告两例病例，其中对恶性颅底肿瘤进行整块切除时包括切除部分颈内动脉。第一例中，肿瘤主要位于咽旁间隙并延伸至颅底。进行了部分颞骨切除术以获得暴露以便进行颈动脉重建。第二例涉及对侵犯颈动脉管的复发性恶性混合瘤进行整块颞骨切除术。两例均通过自体大隐静脉移植实现血管重建。患者术后未出现缺血性神经后遗症。这是已知首例针对恶性颅底肿瘤进行颈内动脉颞内部分远端吻合的颈动脉搭桥手术。作者建议将此手术作为颅底肿瘤手术中需要切除颈动脉时替代颈动脉结扎术的一种选择。
