Intraoperative hybrid technique for excision of temporal bone paraganglioma: A case report.
angiography
case report
glomus tympanicum
mastoidectomy
paraganglioma
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
09 Feb 2024
09 Feb 2024
Historique:
revised:
16
01
2024
received:
20
09
2023
accepted:
23
01
2024
medline:
9
2
2024
pubmed:
9
2
2024
entrez:
9
2
2024
Statut:
aheadofprint
Résumé
Temporal bone paragangliomas are vascularized neoplasms. Although preoperative angioembolization serves as a valuable approach to reduce intraoperative blood loss, it comes with an elevated risk of cranial neuropathies, offers no assurance of complete hemostasis, and precludes real-time adjustments during surgery. A 74-year-old patient presented with recurrent episodes of ear bleeding. On examination, a vascular lesion obstructed her external auditory canal. It had the clinical and radiological characteristics of a paraganglioma. Angiography revealed that it had three feeding vessels. The patient was successfully scheduled for hybrid, intraoperative angiography and temporary balloon occlusion of the feeding vessels supplying the lesion instead of preoperative angioembolization. Utilizing hybrid intraoperative angiography with temporary balloon occlusion during the surgical removal of temporal bone paragangliomas represents an innovative technique that reduces the risk of permanent cranial neuropathies while providing the capacity for real-time adjustments and improved hemostasis.
Sections du résumé
BACKGROUND
BACKGROUND
Temporal bone paragangliomas are vascularized neoplasms. Although preoperative angioembolization serves as a valuable approach to reduce intraoperative blood loss, it comes with an elevated risk of cranial neuropathies, offers no assurance of complete hemostasis, and precludes real-time adjustments during surgery.
METHODS
METHODS
A 74-year-old patient presented with recurrent episodes of ear bleeding. On examination, a vascular lesion obstructed her external auditory canal. It had the clinical and radiological characteristics of a paraganglioma. Angiography revealed that it had three feeding vessels.
RESULTS
RESULTS
The patient was successfully scheduled for hybrid, intraoperative angiography and temporary balloon occlusion of the feeding vessels supplying the lesion instead of preoperative angioembolization.
CONCLUSIONS
CONCLUSIONS
Utilizing hybrid intraoperative angiography with temporary balloon occlusion during the surgical removal of temporal bone paragangliomas represents an innovative technique that reduces the risk of permanent cranial neuropathies while providing the capacity for real-time adjustments and improved hemostasis.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
Boedeker CC. Paragangliomas and paraganglioma syndromes. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc03. doi:10.3205/cto000076
Jackson CG. Glomus tympanicum and glomus jugulare tumors. Otolaryngol Clin North Am. 2001;34(5):941-970. doi:10.1016/s0030-6665(05)70356-x
Depauw P, Defreyne L, Dewaele F, Caemaert J. Endovascular treatment of a giant petrous internal carotid artery aneurysm. Case report and review of the literature. Minim Invasive Neurosurg. 2003;46:250-253.
Gjuric M, Gleeson M. Consensus statement and guidelines on the management of paragangliomas of the head and neck. Skull Base. 2009;19(1):109-116.
Devuyst L, Defreyne L, Praet M, Geukens S, Dhooge I. Treatment of glomus tympanicum tumors by preoperative embolization and total surgical resection. Am J Otolaryngol. 2016;37(6):544-551.
Warren FM 3rd, McCool RR, Hunt JO, et al. Preoperative embolization of the inferior petrosal sinus in surgery for glomus jugulare tumors. Otol Neurotol. 2011;32(9):1538-1541.
Gaynor BG, Elhammady MS, Jethanamest D, Angeli SI, Aziz-Sultan MA. Incidence of cranial nerve palsy after preoperative embolization of glomus jugulare tumors using Onyx. J Neurosurg. 2014;120(2):377-381. doi:10.3171/2013.10.JNS13354
Helal A, Vakharia K, Brinjikji W, et al. Preoperative embolization of jugular paraganglioma tumors using particles is safe and effective. Interv Neuroradiol. 2022;28(2):145-151. doi:10.1177/15910199211019175
Chen CC, Chen CT, Wu YM, et al. Direct carotid artery exposure for acute cerebral infarction in hybrid angiography suite: indications and limitations. Front Surg. 2022;8:819053. doi:10.3389/fsurg.2021.819053
Akhtar NJ, Oderich GS, Vrtiska TJ, Williamson EE, Araoz PA. Computed tomography angiography of hybrid thoracic endovascular aortic repair of the aortic arch. Expert Rev Cardiovasc Ther. 2013;11(5):589-606. doi:10.1586/erc.13.47
Yue JK, Chang D, Caton MT Jr, et al. The hybrid operative suite with intraoperative biplane rotational angiography in pediatric cerebrovascular neurosurgery: utility and lessons learned. Pediatr Neurosurg. 2022;57(4):245-259. doi:10.1159/000524875
Gardner G, Cocke EW Jr, Robertson JT, Trumbull ML, Palmer RE. Combined approach surgery for removal of glomus jugulare tumors. Laryngoscope. 1977;87(5):665-688. doi:10.1002/lary.5540870503
Zhang N, Xin WQ. Application of hybrid operating rooms for treating spinal dural arteriovenous fistula. World J Clin Cases. 2020;8(6):1056-1064. doi:10.12998/wjcc.v8.i6.1056
Almefty RO, Patel NJ, See AP, Dunn IF, Al-Mefty O, Aziz-Sultan MA. Hybrid surgery management of giant hypervascular tumors: intraoperative endovascular embolization with microsurgical resection. World Neurosurg. 2017;102:157-166. doi:10.1016/j.wneu.2017.02.092