Andrea Bacciu1, Sampath Chandra Prasad2, Natalie Sist3, Giulia Rossi1, Paolo Piazza4, Mario Sanna2. 1. Department of Clinical and Experimental Medicine, Otolaryngology Unit, University-Hospital of Parma, Parma, Italy. 2. Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy. 3. Department of Otolaryngology, Eastern Health, Box Hill, Victoria, Australia. 4. Department of Neuroradiology, University-Hospital of Parma, Parma, Italy.
Abstract
BACKGROUND: Management of the cervical and petrous internal carotid artery (ICA) is frequently required in Fisch class C tympanojugular paragangliomas (TJPs). The purpose of this study was to discuss the perioperative intervention of the ICA in patients who underwent surgical resection of a TJP. METHODS: A retrospective study of 237 patients surgically treated for Fisch class C TJPs was done to identify cases that required ICA management. RESULTS: Management of the ICA was required in 176 patients (74.2%). Forty-two patients required just an ICA decompression, 88 underwent a subperiosteal dissection, 19 underwent subadventitial dissection without intraluminal stenting, 17 underwent subadventitial dissection with intraluminal stenting, and 12 underwent arterial resection after permanent balloon occlusion. There were no complications associated with the endovascular procedures. Gross total tumor resection was achieved in 91.5% of the cases. CONCLUSION: Preoperative endovascular intervention, in selected cases, facilitates gross total tumor removal and significantly reduces the risk of an intraoperative ICA injury.
BACKGROUND: Management of the cervical and petrous internal carotid artery (ICA) is frequently required in Fisch class C tympanojugular paragangliomas (TJPs). The purpose of this study was to discuss the perioperative intervention of the ICA in patients who underwent surgical resection of a TJP. METHODS: A retrospective study of 237 patients surgically treated for Fisch class C TJPs was done to identify cases that required ICA management. RESULTS: Management of the ICA was required in 176 patients (74.2%). Forty-two patients required just an ICA decompression, 88 underwent a subperiosteal dissection, 19 underwent subadventitial dissection without intraluminal stenting, 17 underwent subadventitial dissection with intraluminal stenting, and 12 underwent arterial resection after permanent balloon occlusion. There were no complications associated with the endovascular procedures. Gross total tumor resection was achieved in 91.5% of the cases. CONCLUSION: Preoperative endovascular intervention, in selected cases, facilitates gross total tumor removal and significantly reduces the risk of an intraoperative ICA injury.
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