Fruhwirth J, Koch G, Klein G E
Klinische Abteilung für Gefässchirugie, Karl Franzens Universität Graz.
HNO. 1996 Sep;44(9):510-3. doi: 10.1007/s001060050046.
During surgical resections carotid body tumors may bleed profusely due to their vascularity. Preoperative angiographic embolization of tumor-supplying arteries has reduced intraoperative blood loss significantly. The present study reviews our clinical experiences with 13 paragangliomas of the carotid bifurcation in 12 patients during the past 5 years. In 6 patients (46.1%) computed tomography and magnetic resonance imaging demonstrated extensive spread of the tumor up to the base of the skull. Tumors of this size were initially assessed as being inoperable but curative surgical resections were performed after embolization of tumor-supplying arteries by intravascular injections of Gelfoam and implantations of microcoils. Vascular reconstruction of the internal carotid artery by a saphenous vein graft was required in 4 patients (30.7%). In 3 malignant paragangliomas (23.0%) adjuvant radiotherapy of 50-60 Gy was administered to the tumor site after surgery. During an average follow-up of 29 months, one malignant paraganglioma was found to have recurred locally 13 months after initial therapy.
在手术切除过程中，颈动脉体瘤因其血管丰富可能会大量出血。术前对肿瘤供血动脉进行血管造影栓塞术已显著减少了术中失血。本研究回顾了我们在过去5年中对12例患者的13个颈动脉分叉副神经节瘤的临床经验。6例患者（46.1%）的计算机断层扫描和磁共振成像显示肿瘤广泛扩散至颅底。这种大小的肿瘤最初被评估为无法手术切除，但在通过血管内注射明胶海绵栓塞肿瘤供血动脉并植入微线圈后进行了根治性手术切除。4例患者（30.7%）需要用大隐静脉移植对颈内动脉进行血管重建。3例恶性副神经节瘤（23.0%）在术后对肿瘤部位进行了50 - 60 Gy的辅助放疗。在平均29个月的随访期间，发现1例恶性副神经节瘤在初始治疗后13个月出现局部复发。
