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Management of Multiple Head and Neck Paragangliomas With Assistance of a 3-D Model.
- Source :
-
ENT: Ear, Nose & Throat Journal . Jun2023, Vol. 102 Issue 6, p362-368. 7p. - Publication Year :
- 2023
-
Abstract
- Introduction: Extirpation of multiple head and neck paragangliomas carries challenge due to close anatomic relationships with critical neurovascular bundles. Objectives: This study aims to assess whether the application of 3-D models can assist with surgical planning and treatment of these paragangliomas, decrease surgically related morbidity and mortality. Methods: Fourteen patients undergoing surgical resection of multiple head and neck paragangliomas were enrolled in this study. A preoperative 3-D model was created based on radiologic data, and relevant critical anatomic relationships were preoperatively assessed and intraoperatively validated. Results: All 14 patients presented with multiple head and neck paragangliomas, including bilateral carotid body tumors (CBT, n = 9), concurrent CBT with glomus jugulare tumors (GJT, n = 4), and multiple vagal paragangliomas (n = 1). Ten patients underwent genomic analysis and all harbored succinate dehydrogenase complex subunit D (SDHD) mutations. Under guidance of the 3-D model, the internal carotid artery (ICA) was circumferentially encased by tumor on 5 of the operated sides, in 4 (80%) of which the tumor was successfully dissected out from the ICA, whereas ICA reconstruction was required on one side (20%). Following removal of CBT, anterior rerouting of the facial nerve was avoided in 3 (75%) of 4 patients during the extirpation of GJT with assistance of a 3-D model. Two patients developed permanent postoperative vocal cord paralysis. There was no vessel rupture or mortality in this study cohort. Conclusion: The 3-D model is beneficial for establishment of a preoperative strategy, as well as planning and guiding the intraoperative procedure for resection of multiple head and neck paragangliomas. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PREOPERATIVE care
*THREE-dimensional imaging
*GENETIC mutation
*NURSING care plans
*OPERATIVE surgery
*INTRAOPERATIVE care
*HEAD & neck cancer
*HUMAN anatomical models
*DISEASES
*TREATMENT effectiveness
*GENOMICS
*DESCRIPTIVE statistics
*RESEARCH funding
*PARAGANGLIOMA
*COMPUTED tomography
*DISEASE management
*LONGITUDINAL method
*GLOMUS jugulare tumors
Subjects
Details
- Language :
- English
- ISSN :
- 01455613
- Volume :
- 102
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- ENT: Ear, Nose & Throat Journal
- Publication Type :
- Academic Journal
- Accession number :
- 164011179
- Full Text :
- https://doi.org/10.1177/01455613211009441