Preoperative Embolization in the Management of Neck Paragangliomas
Autor: | M. Päivänsalo, Kalevi Hyrynkangas, Outi Heikkilä, Sami Leinonen, Tapani Tikkakoski, Jukka Luotonen, Topi Siniluoto |
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Rok vydání: | 1997 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Paraganglioma Preoperative embolization Blood loss Preoperative Care medicine Humans Operation time Embolization business.industry Middle Aged University hospital medicine.disease Embolization Therapeutic Surgery Otorhinolaryngology Head and Neck Neoplasms Polyvinyl Alcohol Cranial Nerve Injury Female Ultrasonography business |
Zdroj: | The Laryngoscope. 107:821-826 |
ISSN: | 1531-4995 0023-852X |
DOI: | 10.1097/00005537-199706000-00018 |
Popis: | Surgery of neck paragangliomas carries inherent risks of excessive blood loss and cranial nerve injury. Preoperative embolization has been used to lessen the morbidity of surgery. We sought to characterize our experience with preoperative embolization by evaluating safety, efficacy, and surgical data. During a period of 22 years (1974 to 1996), 19 consecutive patients with 27 histopathologically confirmed neck paragangliomas were surgically treated at the Oulu University Hospital. All patients underwent preoperative arteriography and 17 patients had cervical ultrasonography (US). Eleven patients with 15 tumors were operated on without embolization and nine patients with 12 tumors were preoperatively embolized with 150- to 250-microm polyvinyl alcohol (PVA) particles. The mean blood loss during surgery in the nonembolized group was 1374 mL (range, 100 to 4500 mL) and the mean operation time was 4 hours and 48 minutes (range, 1.5 to 9 hours). In the embolized group the mean blood loss was significantly less (588 mL; range, 100 to 1800 mL; P = 0.04) and the mean operation time shorter (3 hours 24 minutes; range, 2 to 5 hours; P = 0.05). No embolic complications were recorded after the embolization. We conclude that preoperative embolization of neck paragangliomas 3 cm or greater in diameter with PVA particles is safe. Embolization to minimize operative bleeding facilitates surgery, shortens the operation time, and lessens the surgical risks. |
Databáze: | OpenAIRE |
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