OBJECTIVE: To report 3 unique cases of cranial neuropathy after super-selective arterial embolization of jugular foramen vascular tumors with ethylene vinyl alcohol. STUDY DESIGN: Clinical capsule report. SETTING: Three tertiary academic referral hospitals. PATIENTS: Three patients who underwent superselective arterial embolization (SSE) of head and neck paragangliomas with ethylene vinyl alcohol are described. One individual was treated with primary SSE, whereas the remaining tumors were treated with preoperative SSE followed by surgical extirpation within 72 hours. All patients were found to have new cranial nerve deficits after SSE. RESULTS: One patient with isolated complete cranial nerve VII palsy demonstrated partial return of function at 8 months. One individual experienced cranial nerve VII, X, and XII palsies and demonstrated partial recovery of function of the involved facial nerve after 19 months. One subject experienced ipsilateral cranial nerve X and XI palsies after SSE and recovered full function of the spinal accessory nerve within 1 week but failed to demonstrate mobility of the ipsilateral true vocal fold. CONCLUSION: We present the first report documenting facial and lower cranial neuropathies after super-selective embolization of head and neck paragangliomas with EVA. Although it is difficult to draw conclusions from this small number of cases, it is plausible that the use of ethylene vinyl alcohol during SSE may result in a higher risk of permanent cranial neuropathy than the use of other well-established and more temporary agents. Knowledge of the arterial supply to the cranial nerves can help the clinician to choose the embolization agent that will provide maximal occlusion while minimizing the risk of complications.
OBJECTIVE: To report 3 unique cases of cranial neuropathy after super-selective arterial embolization of jugular foramen vascular tumors with ethylene vinyl alcohol. STUDY DESIGN: Clinical capsule report. SETTING: Three tertiary academic referral hospitals. PATIENTS: Three patients who underwent superselective arterial embolization (SSE) of head and neck paragangliomas with ethylene vinyl alcohol are described. One individual was treated with primary SSE, whereas the remaining tumors were treated with preoperative SSE followed by surgical extirpation within 72 hours. All patients were found to have new cranial nerve deficits after SSE. RESULTS: One patient with isolated complete cranial nerve VII palsy demonstrated partial return of function at 8 months. One individual experienced cranial nerve VII, X, and XII palsies and demonstrated partial recovery of function of the involved facial nerve after 19 months. One subject experienced ipsilateral cranial nerve X and XI palsies after SSE and recovered full function of the spinal accessory nerve within 1 week but failed to demonstrate mobility of the ipsilateral true vocal fold. CONCLUSION: We present the first report documenting facial and lower cranial neuropathies after super-selective embolization of head and neck paragangliomas with EVA. Although it is difficult to draw conclusions from this small number of cases, it is plausible that the use of ethylene vinyl alcohol during SSE may result in a higher risk of permanent cranial neuropathy than the use of other well-established and more temporary agents. Knowledge of the arterial supply to the cranial nerves can help the clinician to choose the embolization agent that will provide maximal occlusion while minimizing the risk of complications.
Authors: Frank M Warren; Ryan R McCool; Jason O Hunt; Nan Hu; Perry P Ng; Luke P Buchmann; Clough Shelton Journal: Otol Neurotol Date: 2011-12 Impact factor: 2.311
Authors: Ahmed Helal; Kunal Vakharia; Waleed Brinjikji; Matthew L Carlson; Colin Lw Driscoll; Jamie J Van Gompel; Michael J Link; Harry Cloft Journal: Interv Neuroradiol Date: 2021-05-26 Impact factor: 1.764
Authors: Benedicto Oscar Colli; Carlos Gilberto Carlotti Junior; Ricardo Santos de Oliveira; Guilherme Gozzoli Podolski Gondim; Daniel Giansanti Abud; Eduardo Tanaka Massuda; Francisco Veríssimo de Melo Filho; Koji Tanaka Journal: Surg Neurol Int Date: 2021-09-30