Clinical application of combined infratemporal fossa approaches for internal carotid artery in petrous bone reconstruction for large lateral skull base tumors.
10.3760/cma.j.cn115330-20200613-00500
- VernacularTitle:联合颞下窝进路颈内动脉重建技术在侧颅底巨大肿瘤切除术中的应用
- Author:
Guo Dong FENG
1
;
Xing Mei WEI
1
;
Yue Hong ZHENG
2
;
Tao ZHANG
3
;
Xu TIAN
1
;
Yang ZHAO
1
;
Ya Lin ZHOU
4
;
Zhi Qiang GAO
1
Author Information
1. Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
2. Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
3. Department of Oral and Maxillofacial Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
4. Department of Anesthesia, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
- Publication Type:Journal Article
- MeSH:
Adult;
Carotid Artery, Internal/surgery*;
Female;
Humans;
Infratemporal Fossa;
Male;
Middle Aged;
Neoplasm Recurrence, Local;
Petrous Bone/surgery*;
Skull Base/surgery*;
Skull Base Neoplasms/surgery*
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2021;56(5):417-423
- CountryChina
- Language:Chinese
-
Abstract:
Objective: By summarizing the technical points and therapeutic outcomes of combing infratemporal fossa approach (IFA) and internal carotid artery (ICA) reconstruction for the colossal skull base tumor invading ICA in petrous bone, the clinical application value was discussed. Methods: Five patients (2 males, 3 females,aging from 27 to 55 years old) who received surgeries between July 2015 and May 2017 for lateral skull base pathology involved petrous ICA using technique combined IFA and pre-reconstruction, were reviewed. Results: Among the five patients, three were paraganglioma of head and neck, one was carotid aneurysms, and one was recurrent adenoid cystic carcinoma (ACC). The median tumor size in the largest cross-section was 60 mm × 51 mm (range, 28 mm × 22 mm-72 mm × 58 mm). Complete excision was achieved with IFA and ICA reconstruction. The median blood loss volume was 1 000 ml (range, 600-2 500 ml). Four cases showed no new long-term neurologic sequelae, while one showed hemiplegia due to graft vessel occlusion. Except for the one with ACC having facial nerve cut, others achieved good facial nerve function of HB grade Ⅰ to Ⅱ during 3 to 12 months, follow-up. No tumor recurrence was observed over the median duration of follow-up for above 36 months (range, 36-58 months). Conclusion: For lesions involved superior part of ICA, which is unable to separate from ICA, IFA and ICA reconstruction can achieve complete excision.
