Surgical removal of jugular paragangliomas after stenting of the intratemporal internal carotid artery: a preliminary report.
OBJECTIVE
Jugular paragangliomas with extensive involvement of the internal carotid artery (ICA) represent a true challenge for surgeons, especially in the presence of inadequate collateral circulation through the circle of Willis. The aim of our study is to present a preliminary report of our experience with the surgical removal of three such cases using the stenting of the ICA as the method of choice for protecting and preserving the integrity of the artery.


METHODS
This retrospective study was conducted at Gruppo Otologico, a private referral center for neurotology and skull base surgery. The subjects of our study are three cases of jugular paragangliomas with extensive involvement of the ICA and inadequate collateral circulation. These cases are the first three cases operated at our center after stenting of the intratemporal portion of the ICA.


RESULTS
Complete surgical removal of the tumor, including the part involving the ICA, was achieved in all cases. Over a follow-up period of 22 to 30 months, no complications occurred and the patency of the stented arteries was preserved.


CONCLUSIONS
Although more follow-up is still needed before establishing the exact long-term outcome of stenting the intratemporal ICA, our preliminary report shows that the stent has facilitated the complete surgical removal of the tumor, preserving the integrity of the ICA.
Sanna
Mario
M
Gruppo Otologico Piacenza, Rome Italy.
Khrais
Tarek
T
Menozi
Roberto
R
Piaza
Paolo
P
D000328:Adult; D001707:Biopsy, Needle; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002343:Carotid Artery, Internal / Q000601:surgery*; D002533:Cerebral Angiography; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D005925:Glomus Jugulare Tumor / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial; D014654:Vascular Patency
D005682:Gadolinium