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首页> 外文期刊>Cureus. >Preoperative Embolization of Fisch Grades II–IVa Juvenile Nasopharyngeal Angiofibromas: Transarterial Embolization in the Age of Onyx
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Preoperative Embolization of Fisch Grades II–IVa Juvenile Nasopharyngeal Angiofibromas: Transarterial Embolization in the Age of Onyx

机译：FISCH等级II-IVA青少年鼻咽血管纤维瘤的术前栓塞：ONYX时代的常规栓塞

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Objective The current mainstay treatment for juvenile nasopharyngeal angiofibromas (JNAs) is surgical resection, but embolization of primary feeding arteries through endovascular transarterial and direct tumoral puncture embolizations with various agents has been described. We describe a single institutional experience with JNA embolization utilizing Onyx (Medtronic, Dublin, Ireland). Methods A retrospective records review was performed to identify patients who underwent embolization for devascularization of Fisch grades II-IVa JNA (tumor extension beyond the sphenopalatine region) before surgical resection between 2010 and 2019. Fluoroscopy time, grade, intraoperative blood loss, and clinical follow-up data were compiled. Tumor devascularization percentage was calculated using ImageJ software (public domain, BSD-2) by measuring the ratio of preoperative and postoperative embolization tracing. Results Five consecutive patients (ages 12-16 years [average 14 years]; all male) with JNAs underwent preoperative transarterial embolizations performed under general anesthesia. All patients presented with epistaxis; two also presented with headaches. Fisch grades were II in two patients, IIIa in two, and IVa in one. The patient with the grade IVa lesion underwent direct transtumoral puncture and Onyx embolization. The mean percentage of all tumor devascularizations postembolization was 86.0±9.7%. Complete resection 24-48 hours postembolization was obtained for grades II and IIIa lesions with 700 mL blood loss. No embolization-related complications and no clinical sequelae were present in the five cases after embolization. Conclusion In our experience, Onyx embolization of JNAs was safely conducted with adequate tumor penetration beyond the sphenopalatine region through transarterial routes.
机译：目的目的，用于幼苗鼻咽血管纤维瘤（JNA）的目前的主干处理是手术切除，但已经描述了通过血管内培养和直接肿瘤穿刺栓塞与各种试剂的栓塞栓塞。我们描述了利用Onyx的JNA栓塞的单一制度经验（Medtronic，Dublin，爱尔兰）。方法对2010年至2019年间手术切除之前，进行了回顾性记录审查，以鉴定患者患者对抗血管异常II-IVA JNA的抗栓塞（肿瘤突氨酸区域）的抗栓塞症的患者。透视时间，等级，术中失血和临床跟随编译了-UP数据。通过测量术前和术后栓塞跟踪的比率，使用imagej软件（公共领域，BSD-2）计算肿瘤偏移百分比。结果5名患者（12-16岁[平均14岁];所有雄性）与JNA接受术前常产腐殖栓塞在全身麻醉下进行。所有患者患有epistaxis;两人也呈现出头痛。 FISCH等级在两名患者中，IIIA，IIA和IVA一体。患者患有IVA病变等级的直接进行直接的扭曲刺穿和肉瘤栓塞。所有肿瘤透过血管强化后栓塞的平均百分比为86.0±9.7％。 24-48小时完全切除后24-48小时，获得II等级和IIIA病变，具有＆ 700毫升失血。在栓塞后的五种情况下，在五种情况下，没有栓塞相关的并发症和没有临床后遗症。结论在我们的经验中，通过Transarial途径安全地进行了足够的肿瘤渗透率进行了足够的肿瘤渗透。

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