Background

Jugular paragangliomas represent a surgical challenge due to their vascularity and proximity to vital neurovascular structures. Preoperative embolization aids in reducing intraoperative blood loss, transfusion requirements, and improves surgical visualization. Several embolization agents have been used.

Objective

The aim of this study is to evaluate the safety and efficacy of PVA in pre-operative embolization of jugular paragangliomas.

Methods

A retrospective review of all patients who underwent jugular paraganglioma resection with pre-operative embolization between 2000 and 2020 was performed. Pre-operative data including baseline patient and tumor characteristics were documented. Outcomes of preoperative embolization including extent of devascularization and post-embolization complications were recorded. Early and long-term postoperative outcomes were reported.

Results

Twenty-nine patients met study criteria with a median age of 38 years. Average tumor size was 3.4±1.8 cm. The most commonly encountered arterial feeder was the ascending pharyngeal artery followed by the posterior auricular artery. More than 50% reduction in tumor blush was achieved in 25 patients (86.2%). None of the patients experienced new or worsening cranial neuropathy following embolization. Gross total or Near total resection was achieved in 13 patients (44.8%). A STR or NTR was chosen in these patients to preserve cranial nerve function or large vessel integrity. Average intraoperative estimated blood loss was 888 ml, 9 patients (31%) required intra-operative transfusion of blood products. Extent of resection and post-operative complications did not correlate with extent of devascularization.

Conclusion

Pre-operative embolization of jugular paraganglioma tumors with PVA particles is an effective strategy with a high safety profile.

中文翻译：

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颗粒术前栓塞颈静脉副神经节瘤安全有效

背景

颈静脉副神经节瘤因其血管丰富且靠近重要的神经血管结构而成为外科手术的挑战。术前栓塞有助于减少术中失血、输血需求并改善手术可视化。已经使用了几种栓塞剂。

客观的

本研究的目的是评估 PVA 在颈静脉副神经节瘤术前栓塞术中的安全性和有效性。

方法

对 2000 年至 2020 年间接受颈静脉副神经节瘤切除术和术前栓塞术的所有患者进行了回顾性分析。记录了包括基线患者和肿瘤特征在内的术前数据。记录术前栓塞的结果，包括血管切断的程度和栓塞后并发症。报告了早期和长期的术后结果。

结果

29 名患者符合研究标准，中位年龄为 38 岁。平均肿瘤大小为 3.4±1.8 cm。最常见的供血动脉是咽升动脉，其次是耳后动脉。25 名患者 (86.2%) 的肿瘤红色减少了 50% 以上。栓塞后没有患者出现新的或恶化的颅神经病变。13 名患者 (44.8%) 实现了全切除或近全切除。在这些患者中选择 STR 或 NTR 以保护颅神经功能或大血管完整性。术中平均估计失血量为888毫升，9例（31%）患者术中需要输血。切除范围和术后并发症与血管切断程度无关。

结论

用 PVA 颗粒对颈静脉副神经节瘤进行术前栓塞是一种有效且安全性高的策略。