A Multidisciplinary Approach to Carotid Paragangliomas

摘要: The surgical management of carotid paragangliomas can be problematic. A multidisciplinary approach was used to include vascular surgery, otolaryngology, and neuroradiology treat these patients over 9 years. From January 1992 July 2001, a team evaluated with paragangliomas. Analyzed patient data included age, gender, diagnostic evaluation, tumor size, preoperative embolization, operative exposure, need for extracranial arterial sacrifice/reconstruction, postoperative morbidity including cranial nerve dysfunction, long-term follow-up. Twenty-five in 20 underwent evaluation management. Average age 51 years (range, 28-83 years), 52% were male. Diagnostic computed tomography 76%, magnetic resonance imaging/magnetic angiography 52%, catheter 60%, duplex ultrasonography 16%. An extended neck exposure required 11 cases (44%), mandibulotomy once (4%), mandibular subluxation never required. external artery (ECA) sacrificed 8 (32%). bifurcation resected 1 (4%) requiring interposition reconstruction the internal artery. Preoperative embolization performed 13 tumors (52%). Operative blood loss undergoing (Group I) comparable nonembolized group (group II): I lost 365 +/-180 mL versus 360 +/- 101 II (P = .48). This occurred despite larger - 4.2 cm 2.1 cm, P .03) higher mean Shamblin class 2.5 1.45, .001) I. There no perioperative mortalities. Transient dysfunction CBTs (52%), 2 (8%) which remained present after 4 months. Patients benefit from approach. Neuroradiology has been selective decreased estimated during excision complex tumors. combined otolaryngology surgery provides distal as high skull base, limited permanent early division complete resection.