Tranbahuy P, Borsik M, Herman P, Wassef M, Casasco A
Department of Otorhinolaryngology, Hôpital Lariboisière, Paris, France.
Am J Otolaryngol. 1994 Nov-Dec;15(6):429-35. doi: 10.1016/0196-0709(94)90084-1.
Embolization is a well-established technique that facilitates the subsequent surgical removal of vascularized tumors such as juvenile angiofibroma. However, there is risk of a neurological accident during angiography and tumor embolization from the internal carotid artery. Direct intratumoral embolization may help prevent these potential side effects.
A group of 7 patients with juvenile angiofibroma vascularized through the branches of the internal carotid artery underwent direct tumoral embolization under general anesthesia. An injection made slowly with an intranasal or lateral percutaneous route with either a mixture of cyanoacrylate, lipiodal, and tungsten powder. Continuous radiographic control was used.
This technique induced a marked devascularization and necrosis of the tumor. The technique provided useful perioperative visualization of the tumor. No neurologic sequelae were encountered.
Direct intratumoral embolization deserves further consideration. This might be especially important in tumors with extracranial extension, cavernous sinus involvement, or those with small or multiple recurrences.
栓塞术是一种成熟的技术，有助于后续手术切除血管化肿瘤，如青少年血管纤维瘤。然而，在血管造影和经颈内动脉进行肿瘤栓塞期间存在神经意外的风险。直接瘤内栓塞可能有助于预防这些潜在的副作用。
一组7例通过颈内动脉分支血管化的青少年血管纤维瘤患者在全身麻醉下接受直接瘤内栓塞。采用鼻内或经皮外侧途径缓慢注射氰基丙烯酸酯、碘油和钨粉的混合物。使用连续的影像学监测。
该技术导致肿瘤明显的血管减少和坏死。该技术为围手术期肿瘤可视化提供了帮助。未出现神经后遗症。
直接瘤内栓塞值得进一步考虑。这在伴有颅外扩展、海绵窦受累或小的或多发性复发的肿瘤中可能尤为重要。
