Facial and Lower Cranial Neuropathies After Preoperative Embolization of Jugular Foramen Lesions With Ethylene Vinyl Alcohol

被引:25
作者
Gartrell, Brian C. [1 ]
Hansen, Marlan R. [2 ]
Gantz, Bruce J. [2 ]
Gluth, Michael B. [3 ]
Mowry, Sarah E. [4 ]
Aagaard-Kienitz, Beverly L. [5 ]
Baskaya, Mustafa K. [6 ]
Gubbels, Samuel P. [1 ,7 ]
机构
[1] Univ Wisconsin, Dept Surg, Div Otolaryngol Head & Neck Surg, Sect Otol & Neurotol, Madison, WI 53792 USA
[2] Univ Iowa, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA
[3] Univ Arkansas Med Sci, Dept Otolaryngol Head & Neck Surg, Little Rock, AR 72205 USA
[4] Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA
[5] Univ Wisconsin, Dept Radiol, Neuroradiol Sect, Madison, WI 53792 USA
[6] Univ Wisconsin, Dept Neurol Surg, Madison, WI 53792 USA
[7] Univ Wisconsin, Waisman Ctr, Madison, WI 53705 USA
关键词
Carotid body tumor; Cranial neuropathy; Ethylene vinyl alcohol; Glomus jugulare; Super-selective embolization; TUMOR EMBOLIZATION; GLOMUS TUMORS; HEAD; NECK; PALSY; ONYX;
D O I
10.1097/MAO.0b013e31825f2365
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To report 3 unique cases of cranial neuropathy after super-selective arterial embolization of jugular foramen vascular tumors with ethylene vinyl alcohol. Study Design: Clinical capsule report. Setting: Three tertiary academic referral hospitals. Patients: Three patients who underwent super-selective arterial embolization (SSE) of head and neck paragangliomas with ethylene vinyl alcohol are described. One individual was treated with primary SSE, whereas the remaining tumors were treated with preoperative SSE followed by surgical extirpation within 72 hours. All patients were found to have new cranial nerve deficits after SSE. Results: One patient with isolated complete cranial nerve VII palsy demonstrated partial return of function at 8 months. One individual experienced cranial nerve VII, X, and XII palsies and demonstrated partial recovery of function of the involved facial nerve after 19 months. One subject experienced ipsilateral cranial nerve X and XI palsies after SSE and recovered full function of the spinal accessory nerve within 1 week but failed to demonstrate mobility of the ipsilateral true vocal fold. Conclusion: We present the first report documenting facial and lower cranial neuropathies after super-selective embolization of head and neck paragangliomas with EVA. Although it is difficult to draw conclusions from this small number of cases, it is plausible that the use of ethylene vinyl alcohol during SSE may result in a higher risk of permanent cranial neuropathy than the use of other well-established and more temporary agents. Knowledge of the arterial supply to the cranial nerves can help the clinician to choose the embolization agent that will provide maximal occlusion while minimizing the risk of complications.
引用
收藏
页码:1270 / 1275
页数:6
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