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首页> 外文期刊>Auris, nasus, larynx >Endoscopic endonasal transmaxillary ligation of a feeding artery and coblation plasma technology enables en bloc resection of advanced juvenile nasopharyngeal angiofibroma without preoperative embolization
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Endoscopic endonasal transmaxillary ligation of a feeding artery and coblation plasma technology enables en bloc resection of advanced juvenile nasopharyngeal angiofibroma without preoperative embolization

机译：进料动脉和涂层等离子体技术的内窥镜内切和涂层氧化性结扎能够在没有术前栓塞的情况下EN集团切除先进的幼苗鼻咽血管瘤

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摘要

Juvenile nasopharyngeal angiofibroma (JNA) is a hypervascular tumor and uncontrolled hemorrhage makes its removal very difficult. Although preoperative intravascular embolization of a feeding artery is recommended, serious complications such as iatrogenic thrombosis in the brain and insufficient decrease in blood flow to the tumor are concerns. Recently, coblation plasma technology has been reported to be useful for tumor removal with minimum hemorrhage under a clear surgical field. Here we report successful removal of advanced JNA without preoperative embolization, using intraoperative ligation of the maxillary artery and coblation plasma technology. The left nasal cavity of a 23-years-old man was closed by a JNA tumor at Radkowski stage IIC, which was 65 mm in size and extended from the nasal cavity to the infratemporal fossa. MRA imaging showed the maxillary artery running along the posterior wall of the maxillary sinus. Therefore, the maxillary artery was first clipped using an endoscopic modified medial maxillectomy (EMMM) approach and endoscopic endonasal en bloc resection of the tumor was then completed using coblation technology with no need for blood transfusion. This case illustrates that preoperative embolization is dispensable in JNA surgery even at Stage IIC if the maxillary artery can be ligated during surgery and a coblation device can be utilized. (C) 2018 Elsevier B.V. All rights reserved.
机译：少年鼻咽血管纤维瘤（JNA）是一种高血管外肿瘤，不受控制的出血使其去除非常困难。虽然建议术前血管内栓塞饲喂动脉，但脑内脑内的严重并发症如治理血栓形成，血流对肿瘤的降低是令人关切的。最近，据报道，涂层等离子体技术可用于在清晰的外科手术场下具有最小出血的肿瘤去除。在这里，我们报告使用上颌动脉和涂层等离子体技术的术中结扎成功去除高级JNA而无需术前栓塞。在Radkowski Stage IIC下由JNA肿瘤封闭了23岁的人的左鼻腔，其尺寸为65毫米，并从鼻腔延伸到Infratemporal FOSA。 MRA成像显示沿着上颌窦后壁的上颌动脉。因此，首先使用内窥镜修饰的内颌骨菌切除术（emmm）方法夹住上颌动脉，然后使用涂层技术完成肿瘤的内窥镜内切胞型EN集团切除肿瘤切除，不需要输血。这种情况说明，如果可以在手术期间可以连接上颌动脉，并且可以利用涂层装置，即使在阶段IIC，也可以使用术前栓塞在JNA手术中。 （c）2018 Elsevier B.v.保留所有权利。

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