颈动脉体瘤的外科治疗及并发症预防与处理
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摘要
<正>颈动脉体瘤(carotid body tumor,CBT)是发生于颈动脉体的一种罕见副神经节瘤。据估测副神经节瘤在头颈部的发病率大约为1/30 000,其中CBT占65%~[1],常为单侧性,有家族史者多为双侧发病。好发于30～40岁的人群~[2],女性发病率高于男性,大部分为良性,恶性占2%～8%~[3],极少部分具有分泌功能。研究认为,CBT的发生与遗传易感性及环境中慢性低氧刺激有关,雌激素则被
Carotid body tumor is an uncommon paraganglioma tumor in the head and neck region.Carotid angiography remains the gold standard for this tumor.Surgical treatment has been universally accepted as the main treatment of CBT,resection of it is technically challenging because of the location.In order to reduce the morbidity of intraoperative and postoperative complications,we summarize the surgical treatment and the prevention and treatment of complication of this neoplasm,after retrieving the domestic and foreign literature.
Carotid body tumor is an uncommon paraganglioma tumor in the head and neck region.Carotid angiography remains the gold standard for this tumor.Surgical treatment has been universally accepted as the main treatment of CBT,resection of it is technically challenging because of the location.In order to reduce the morbidity of intraoperative and postoperative complications,we summarize the surgical treatment and the prevention and treatment of complication of this neoplasm,after retrieving the domestic and foreign literature.
引文
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[2]METHEETRAIRUT C,CHOTIKAVANICH C,KESKOO P,et al.Carotid body tumor:a 25-year experience[J].Eur Arch Otorhinolaryngol,2016,273:2171-2179.
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[8]KASPER G C,WELLING R E,et al.a multidisciplinary approach to carotid paraganliomas[J].Vasc Endovascular Surg,2006,40:467-474.
[9]曹罡,杨震,张森林,等.颈动脉体瘤治疗中保全颈动脉连续性的处理[J].医学研究生学报,2015,28(6):604-607.
[10]吴海燕,陈金湘,朱海,等.以鼻出血为首发症状的颈内动脉瘤1例[J].临床耳鼻咽喉头颈外科杂志,2016,30(8):665-666.
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[12]SPINELLI F,MASSARA M,LA SPADA M,et al.A simple technique to achieve bloodless excision of carotid body tumors[J].J Vasc Surg,2014,59:1462-1464.
[13]张国民,邹耀祥,冯翔,等.29例颈动脉体瘤手术方式及并发症分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(8):630-632.
[14]张艳,高明,李树玲.不血管重建的肿瘤合并颈动脉切除术[J].中国肿瘤临床,2009,36(4):227-229.
[15]黄德亮,马明莹,刘良发,等.颈动脉体瘤36例手术治疗体会[J].中华耳鼻咽喉头颈外科杂志,2013,48(12):1006-1010.
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[17]AMATO B,BIANCO T,COMPAGNA R.Surgical resection of carotid body paragangliomas:10years of experience[J].Am J Surg,2014,207:293-298.
[18]DAVILA V J,CHANG J M,STONE W M,et al.Current surgical management of carotid body tumors[J].Vasc Surg,2016,64:1703-1710.
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[20]POWER A H,BOWER T C.Impact of preoperative embolization on outcomes of carotid body tumor resections[J].Vasc Surg,2012,56:979-989.
[21]李松奇,叶财盛,胡作军,等.超选择性供瘤血管栓塞后手术切除颈动脉体瘤的临床体会[J].中华医学杂志,2009,89(13):894-897.
[22]CHEN W L,XU L F,TANG Q L,et al.Management of carotid body tumor and pseudoaneurysm after blunt dissection[J].Craniofac Surg,2015,26:477-480.
[23]KRUGER A J,WALKER P J,FOSTER W J,et al.Important observations made managing carotid body tumors during a 25-year experience[J].Vasc Surg,2010,52:1518-1523.
[24]JOSHI M,LATTIMER C R,SHAH B,et al.The known unknowns of perioperative stroke during carotid body tumour resection[J].BMJ Case Rep,2013,2013.
[25]SEN I,STEPHEN E.Neurological complications in carotid body tumors:a 6-year single-center experience[J].Vasc Surg,2013,57:64s-68s.
[26]PARIDAANS M P.Results from craniocaudal carotid body tumor resection:should it be the standard surgical approach[J]?Eur J Vase Endovasc Surg,2013,46:624-629.
[27]SHAH-BECKER S,GOLDENBERG D,GOYAl N,et al.Baroreceptor reflex failure:Review of the literature and the potential impact on patients with head and neck cancer[J].Head Neck,2017,39:2135-2141.
[28]ZENG G,FENG H,ZHAO J,et al.Clinical characteristics and strategy for treatment of functional carotid body tumours[J].Int J Oral Maxillofac Surg,2013,42:436-439.
[2]METHEETRAIRUT C,CHOTIKAVANICH C,KESKOO P,et al.Carotid body tumor:a 25-year experience[J].Eur Arch Otorhinolaryngol,2016,273:2171-2179.
[3]DA GAMA A D,CABRAL G M.Carotid body tumor presenting with carotid sinus syndrome[J].Vasc Surg,2010,52:1668-1670.
[4]马少燕.超声在诊断颈动脉体瘤中的应用[J].实用医技杂志,2013,20(1):39-40.
[5]LUIS A.Carotid body tumors:Surgical experience in 215cases[J].J Cranio Maxillo Fac Surg,2017,45:1472-1477.
[6]SANL A,OZ K,AYDURAN E,et al.Carotid body tumors and our surgical approaches[J].Indian J Otolaryngol Head Neck Surg,2012,64:158-161.
[7]MA Y,HUANG D,LIU L,et al.Surgical treatment of carotid body tumour:a report of 39cases and a new classification of carotid body tumour:our experience[J].Clin Otolaryngol,2014,39:254-247.
[8]KASPER G C,WELLING R E,et al.a multidisciplinary approach to carotid paraganliomas[J].Vasc Endovascular Surg,2006,40:467-474.
[9]曹罡,杨震,张森林,等.颈动脉体瘤治疗中保全颈动脉连续性的处理[J].医学研究生学报,2015,28(6):604-607.
[10]吴海燕,陈金湘,朱海,等.以鼻出血为首发症状的颈内动脉瘤1例[J].临床耳鼻咽喉头颈外科杂志,2016,30(8):665-666.
[11]VAN DER BOGT K E,VRANCKEN PEETERS M P,VAN BAALEN J M,et al.Resection of carotid body tumors:results of anevolving surgical technique[J].Ann Surg,2008,247:877-884.
[12]SPINELLI F,MASSARA M,LA SPADA M,et al.A simple technique to achieve bloodless excision of carotid body tumors[J].J Vasc Surg,2014,59:1462-1464.
[13]张国民,邹耀祥,冯翔,等.29例颈动脉体瘤手术方式及并发症分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(8):630-632.
[14]张艳,高明,李树玲.不血管重建的肿瘤合并颈动脉切除术[J].中国肿瘤临床,2009,36(4):227-229.
[15]黄德亮,马明莹,刘良发,等.颈动脉体瘤36例手术治疗体会[J].中华耳鼻咽喉头颈外科杂志,2013,48(12):1006-1010.
[16]ONG H S,FAN X D.Radical resection of a Shamblin typeⅢcarotid body tumour without cerebro-neurological deficit:Improved technique with preoperative embolization and carotid stenting[J].Oral Maxillofac Surg,2014,43:1427-1430.
[17]AMATO B,BIANCO T,COMPAGNA R.Surgical resection of carotid body paragangliomas:10years of experience[J].Am J Surg,2014,207:293-298.
[18]DAVILA V J,CHANG J M,STONE W M,et al.Current surgical management of carotid body tumors[J].Vasc Surg,2016,64:1703-1710.
[19]KIM G Y,LAWRENCE P F.New predictors of complications in cariotid body tumor resection[J].Vasc Surg,2017,65:1673-1679.
[20]POWER A H,BOWER T C.Impact of preoperative embolization on outcomes of carotid body tumor resections[J].Vasc Surg,2012,56:979-989.
[21]李松奇,叶财盛,胡作军,等.超选择性供瘤血管栓塞后手术切除颈动脉体瘤的临床体会[J].中华医学杂志,2009,89(13):894-897.
[22]CHEN W L,XU L F,TANG Q L,et al.Management of carotid body tumor and pseudoaneurysm after blunt dissection[J].Craniofac Surg,2015,26:477-480.
[23]KRUGER A J,WALKER P J,FOSTER W J,et al.Important observations made managing carotid body tumors during a 25-year experience[J].Vasc Surg,2010,52:1518-1523.
[24]JOSHI M,LATTIMER C R,SHAH B,et al.The known unknowns of perioperative stroke during carotid body tumour resection[J].BMJ Case Rep,2013,2013.
[25]SEN I,STEPHEN E.Neurological complications in carotid body tumors:a 6-year single-center experience[J].Vasc Surg,2013,57:64s-68s.
[26]PARIDAANS M P.Results from craniocaudal carotid body tumor resection:should it be the standard surgical approach[J]?Eur J Vase Endovasc Surg,2013,46:624-629.
[27]SHAH-BECKER S,GOLDENBERG D,GOYAl N,et al.Baroreceptor reflex failure:Review of the literature and the potential impact on patients with head and neck cancer[J].Head Neck,2017,39:2135-2141.
[28]ZENG G,FENG H,ZHAO J,et al.Clinical characteristics and strategy for treatment of functional carotid body tumours[J].Int J Oral Maxillofac Surg,2013,42:436-439.