鼻咽部纤维血管瘤的血管造影表现及手术前栓塞

The Angiography and Pre operative Embolization of Nasopharyngeal Angiofibroma

目的：了解鼻咽部纤维血管瘤的血供情况及术前栓塞对术中出血、手术全切率和术后疗效的影响。材料与方法：对１６ 例鼻咽部纤维血管瘤患者进行数字减影血管造影，并经５Ｆ 造影导管用直径２５０ ～１０００μｍＩｖａｌｏｎ 栓塞肿瘤供血动脉。结果：鼻咽部纤维血管瘤主要由同侧的颌内动脉供血，同侧颈内动脉参与供血的占６／１６ ，对侧颈外动脉参与供血的占５／１６ 。供血动脉栓塞后肿瘤染色大部分消失，术中出血明显减少。结论：鼻咽纤维血管瘤的术前栓塞有助于减少术中出血，增加手术安全性，提高手术全切率和术后疗效。

Purpose: To observe the blood supply of nasopharyngeal angiofibroma, and the effect of pre operative embolization on the bleeding during operation, the total removal of the tumor, and the postoperative effect.Materials and methods:The digital substrate angiography (DSA) was performed on 16 patients of nasopharyngeal angiofibroma, and the supply artery of the tumor was embolized with 250～1000μ m Ivalon via 5F catheter. Results: The nasopharyngeal angiofibroma was always supplied by the maxillary artery, the ipsilateral internal carotid artery joined in the tumor supply in 6/16 of the tumors, the contralateral external carotid artery in 5/16 of the tumors. The tumor staining disappeared mostly after the supplying artery was embolized, the bleeding during the operation reduced significantly.Conclusion:The pre operative embolization of the nasopharyngeal angiofibroma contribute to reduce the bleeding during the operation, increase the safety of the operation, improve the total removal of the tumor and postoperative effect.