头颈部及颅底肿瘤的术前栓塞

目的：评价选择性颈外动脉栓塞术辅助治疗头颈及颅内肿瘤的临床应用价值。方法：19例头颈部及颅内肿瘤（脑膜瘤7例，纤维血管瘤3例，脊索瘤2例，神经纤维瘤2例，腺样囊性癌、鼻咽癌、蔓状血管瘤、颈动脉体瘤和鳞状细胞癌各1例）患者经血管造影诊断为高血流肿瘤，供血主要来自颈外动脉分支，使用4F或5F造影导管，经股动脉导入颈外动脉的肿瘤目标血管并注射自制明胶海绵微粒栓塞目标血管。栓塞后1d手术。结果：栓塞后11例（57.9％）患者供血动脉完全不显影，肿瘤不显影。3例术中有暂时头面部疼痛，无其他并发症发生。结论：头颈部及颅内高血流肿瘤的术前颈外供血动脉栓塞能够有效地减少术中出血，是一种安全辅助治疗。应用自制明胶海绵微粒，降低了成本，扩大了该技术的使用范围。

Preoperative embolization for head and neck tumors

Objective:To evaluate the clinical application of selective preoperative embolization of external carotid target artery for head and neck tumors.Methods:19 high-flow head and neck tumors were included in our study. The main supply arteries is from external carotid artery. 4F or 5F angiographic catheter was introduced into target vessels and gelfoam was injected until obliteration of target vessels and disappearing of tumor stain. The surgery was performed in the next day. Results:19 cases including 7 meningiomas, 3 angiofibromas, 2 cordomas, 2 neurofibromas, 1 adenoid cystic carcinoma, 1 NPC, 1 hemangioma racemosum, 1 carotid body tumor and 1 epidermoid carcinoma. After embolization 11(57.9%) of 19 cases presented totally obliteration of tumor supply artery or absence of tumor stain. 3 cases had temporary head pain. No other embolization related complication happened.Conclusion:Selective preoperative embolization of external carotid target artery for head and neck tumors is a safe and effective assistance for the operation.Use of gelfoam may decrease therapy cost and extend application range of the therapy.