Journal article
Facial and Lower Cranial Neuropathies after Preoperative Embolization of Jugular Foramen Lesions with Ethylene Vinyl Alcohol
Otology & neurotology, Vol.33(7), pp.1270-1275
09/2012
DOI: 10.1097/MAO.0b013e31825f2365
PMCID: PMC3581607
PMID: 22801041
Abstract
Objective
To report 3 unique cases of cranial neuropathy after super-selective arterial embolization of jugular foramen vascular tumors with ethylene vinyl alcohol.
Study Design
Clinical capsule report.
Setting
Three tertiary academic referral hospitals.
Patients
Three patients who underwent superselective arterial embolization (SSE) of head and neck paragangliomas with ethylene vinyl alcohol are described. One individual was treated with primary SSE, whereas the remaining tumors were treated with preoperative SSE followed by surgical extirpation within 72 hours. All patients were found to have new cranial nerve deficits after SSE.
Results
One patient with isolated complete cranial nerve VII palsy demonstrated partial return of function at 8 months. One individual experienced cranial nerve VII, X, and XII palsies and demonstrated partial recovery of function of the involved facial nerve after 19 months. One subject experienced ipsilateral cranial nerve X and XI palsies after SSE and recovered full function of the spinal accessory nerve within 1 week but failed to demonstrate mobility of the ipsilateral true vocal fold.
Conclusion
We present the first report documenting facial and lower cranial neuropathies after super-selective embolization of head and neck paragangliomas with EVA. Although it is difficult to draw conclusions from this small number of cases, it is plausible that the use of ethylene vinyl alcohol during SSE may result in a higher risk of permanent cranial neuropathy than the use of other well-established and more temporary agents. Knowledge of the arterial supply to the cranial nerves can help the clinician to choose the embolization agent that will provide maximal occlusion while minimizing the risk of complications.
Details
- Title: Subtitle
- Facial and Lower Cranial Neuropathies after Preoperative Embolization of Jugular Foramen Lesions with Ethylene Vinyl Alcohol
- Creators
- Brian C Gartrell - University of Wisconsin - Madison, Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, 600 Highland Ave, K4/719 CSC c/o Delight Hensler, Madison, WI 53792-7375, 402-910-4488, Fax: 608-252-0925Marlan R Hansen - University of Iowa Department of Otolaryngology – Head and Neck Surgery, 200 Hawkins Dr, 21163 PFP, Iowa City, IA 52242-1078, 319-353-7151Bruce J Gantz - University of Iowa Department of Otolaryngology – Head and Neck Surgery, 200 Hawkins Dr, 21158-A PFP, Iowa City, IA 52242-1078, 319-356-2173Michael B Gluth - University of Arkansas for Medical Sciences, Department of Otolaryngology – Head and Neck Surgery, 4301 West Markham St, Little Rock Arkansas, 72205, 501-686-5140Sarah E Mowry - University of Iowa Hospitals and Clinics, Department of Otolaryngology – Head and Neck SurgeryBeverly L Aagaard-Kienitz - University of Wisconsin - Madison, Department of Radiology, Section of Neuroradiology, 600 Highland Avenue, E3/366 Clinical Science Center, Madison, WI 53792-3252, 608-263-8329Mustafa K Baskaya - University of Wisconsin - Madison, Department of Neurological Surgery, 600 Highland Avenue K4/822 CSC, Madison, WI 53792, 608-262-7303Samuel P Gubbels - University of Wisconsin - Madison, Department of Surgery, Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Neurotology &
- Resource Type
- Journal article
- Publication Details
- Otology & neurotology, Vol.33(7), pp.1270-1275
- DOI
- 10.1097/MAO.0b013e31825f2365
- PMID
- 22801041
- PMCID
- PMC3581607
- NLM abbreviation
- Otol Neurotol
- ISSN
- 1531-7129
- eISSN
- 1537-4505
- Grant note
- UL1 RR025011 || RR / National Center for Research Resources : NCRR
- Language
- English
- Date published
- 09/2012
- Academic Unit
- Molecular Physiology and Biophysics; Neurosurgery; Otolaryngology
- Record Identifier
- 9984006459802771
Metrics
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