BACKGROUND Skull base paragangliomas are highly vascular tumors that are often embolized before surgical resection; however, the safety and efficacy of preoperative embolization using an ethylene vinyl alcohol copolymer (Onyx; Medtronic, Dublin, Republic of Ireland) in these tumors is unknown. This retrospective cohort study evaluated patient outcomes after preoperative embolization of skull base paragangliomas using Onyx. METHODS We retrospectively analyzed data from all patients with skull base paragangliomas who underwent preoperative Onyx embolization at our institution (January 01, 2005-December 31, 2017). Patient, tumor, embolization, and outcomes data were extracted by reviewing inpatient and outpatient clinical and imaging records. RESULTS Seven patients were studied (5/7 [71%] female), 6 with glomus jugulares and 1 with a glomus vagale. The median age was 52 years, and the most common presenting symptom was cranial neuropathy (6/7 [86%]). The tumor vascular supply was from the ascending pharyngeal artery in all 7 cases (100%) with additional feeders including the occipital artery in 5 (71%); internal carotid artery in 3 (43%); middle meningeal, vertebral, and internal maxillary artery each in 2 (29%); and posterior auricular artery in 1 (14%). The median postembolization tumor devascularization was 80% (range, 64-95%). The only postembolization complication was a facial palsy in 1 patient. CONCLUSION Preoperative embolization with Onyx affords excellent devascularization for the majority of skull base paragangliomas, and it may facilitate resection of these hypervascular lesions. The advantages provided by Onyx with respect to penetration of intratumoral vessels must be weighed against the risk of cranial neuropathy.

中文翻译：

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颅底副神经节瘤的玛瑙栓塞：单中心经验。

背景 颅底副神经节瘤是高度血管化的肿瘤，通常在手术切除前栓塞；然而，术前使用乙烯-乙烯醇共聚物（Onyx；美敦力，都柏林，爱尔兰共和国）栓塞治疗这些肿瘤的安全性和有效性尚不清楚。这项回顾性队列研究评估了术前使用 Onyx 栓塞颅底副神经节瘤后患者的预后。方法 我们回顾性分析了所有在我们机构接受术前 Onyx 栓塞术的颅底副神经节瘤患者的数据（2005 年 1 月 1 日至 2017 年 12 月 31 日）。通过查看住院和门诊患者的临床和影像记录，提取了患者、肿瘤、栓塞和结果数据。结果 研究了 7 名患者（5/7 [71%] 女性），其中 6 名患有颈静脉球，1 名患有迷走神经球。中位年龄为 52 岁，最常见的症状是颅神经病变 (6/7 [86%])。所有 7 例（100%）的肿瘤血管供应均来自咽升动脉，5 例（71%）包括枕动脉在内的额外供血管；颈内动脉 3 (43%); 脑膜中动脉、椎骨和上颌内动脉各占 2 个（29%）；和耳后动脉 1 (14%)。中位栓塞后肿瘤去血管化率为 80%（范围为 64-95%）。唯一的栓塞后并发症是 1 名患者的面部麻痹。结论 Onyx 术前栓塞术为大多数颅底副神经节瘤提供了良好的断血管术，并且可能有助于切除这些富含血管的病变。