术前栓塞联合显微手术治疗颈静脉球瘤

Combination Preoperative Embolization and Microsurgery in Treatment for Glomus Jugulare Tumors

目的：评价术前介入栓塞治疗颈静脉球瘤的作用,探讨显微外科切除颈静脉球瘤的策略及技巧。方法：回顾性分析11例颈静脉球瘤患者资料,均术前行超选择性插管造影明确病变部位及其供血动脉,然后灌注聚乙烯醇颗粒（PVA颗粒）适量,2-3天后行开颅手术治疗。结果：11例患者肿瘤主要供血动脉均被栓塞,肿瘤染色消失或减轻;栓塞后行开颅手术切除,术中出血量少、显露好,全切除肿瘤9例。结论：颈静脉球瘤术前栓塞治疗对于减少术中出血有重要作用,术前栓塞联合显微外科手术是治疗颈静脉球瘤的理想方法。

Objective：To invegstation the effects of preoperative embolotherapy in the treatment of glomus jugulare tumors（GJT）,and to explore the technique and stage of microsurgery on glomus jugulare tumors.Methods： Retrospective analyse the data of 11 cases with glomus jugulare tumor,superselective arteriography was performed in all patients to identify the diseased regions and feeding vessels under Seldinger technique.A sufficient quantity of polyvinyl alcohol embolization particles were infused in tumors and tumor were resected 2-3 days after embolization.Results：In 11 cases the primary feeding arteries of tumor were embolized completely and tumor stains disappeared or decreased obviously.The tumors were totally resected with little bleeding,totalresection was achieved in 8 cases,subtotal resection in 2 cases,partial resection in 1 case.Conclusion：GJTs are hypervascular tumors,preoperative DSA can define precisely the location and region of tumor,embolization is very useful to reduce introoperative bleeding.Combination of the preoperative embolization and microsurgical resection is an ideal therapeutic measure for the GJTs.