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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Endoscopic Muscle Repair of Right Internal Carotid Artery Rupture Following Endovascular Procedure
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Endoscopic Muscle Repair of Right Internal Carotid Artery Rupture Following Endovascular Procedure

机译：血管内程序后右内颈动脉破裂的内镜肌修复

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Carotid artery blowout syndrome (CBS) is a deadly complication usually linked to head and neck cancer therapy. We present a different etiology of endoscopic CBS, a complication of endovascular coiling of an intracranial aneurysm, treated with sternocleidomastoid (SCM) muscle graft packing.Case Presentation:An otherwise healthy 55-year-old female presented to the emergency room with right-sided painless vision loss of 23 days. Computed tomography angiography demonstrated a right ophthalmic ICA aneurysm eroding into the right sphenoid sinus with optic nerve compression. Attempted endovascular repair of the aneurysm was complicated by ICA rupture into the sphenoid. An endovascular balloon was inflated proximal to the aneurysm to reduce hemorrhage as ENT performed an endoscopic sphenoidotomy. A hematoma was seen overlying the aneurysm in the superior lateral sphenoid sinus. Layers of SCM muscle were morselized and packed serially. Post-repair angiography showed no further extravasation. Aggressive antiplatelet therapy was initiated. Packing was removed after 14 days. Twenty days postoperatively, the patient had profuse left-sided epistaxis requiring a left sphenopalatine artery ligation. The patient's vision recovered.Discussion:Whereas CBS is often managed by endovascular coil embolism, in our case CBS was caused by this very treatment itself. This case shows the use of SCM muscle graft as an effective repair modality of ICA rupture due to endovascular coiling.Laryngoscope, 2020
机译：颈动脉爆裂综合征（CBS）是一种致命的并发症，通常与头颈部癌症治疗有关。我们提出了内窥镜下CBS的不同病因，CBS是颅内动脉瘤血管内盘绕的并发症，采用胸锁乳突肌（SCM）移植填充治疗。病例介绍：一名健康的55岁女性因右侧无痛性视力丧失23天被送往急诊室。计算机断层血管造影显示右眼ICA动脉瘤侵蚀右蝶窦并压迫视神经。动脉瘤的血管内修复尝试因颈内动脉破裂进入蝶骨而复杂化。在耳鼻喉科进行内窥镜蝶窦切开术时，在动脉瘤附近充气一个血管内球囊以减少出血。上外侧蝶窦动脉瘤上方可见血肿。将SCM肌肉层进行颗粒化并连续包装。修复后血管造影显示没有进一步的外渗。积极的抗血小板治疗开始了。14天后移除包装。术后20天，患者出现大量左侧鼻出血，需要结扎左侧蝶腭动脉。病人的视力恢复了。讨论：虽然CBS通常通过血管内弹簧圈栓塞治疗，但在我们的病例中，CBS是由这种治疗本身引起的。本例显示SCM肌肉移植是血管内缠绕导致颈内动脉破裂的有效修复方式。喉镜，2020年

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