Document Detail


Facial and lower cranial neuropathies after preoperative embolization of jugular foramen lesions with ethylene vinyl alcohol.
MedLine Citation:
PMID:  22801041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Brian C Gartrell; Marlan R Hansen; Bruce J Gantz; Michael B Gluth; Sarah E Mowry; Beverly L Aagaard-Kienitz; Mustafa K Baskaya; Samuel P Gubbels
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  33     ISSN:  1537-4505     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-15     Completed Date:  2013-01-23     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1270-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin 53792-7375, USA. BGartrell@uwhealth.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carotid Body Tumor / therapy*
Cranial Nerve Diseases / etiology*
Embolization, Therapeutic / adverse effects*
Female
Glomus Jugulare Tumor / therapy*
Humans
Middle Aged
Polyvinyls / adverse effects*
Grant Support
ID/Acronym/Agency:
1UL1RR025011/RR/NCRR NIH HHS; 9U54TR000021//PHS HHS; UL1 RR025011/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Polyvinyls; 25067-34-9/ethylene-vinyl alcohol copolymer
Comments/Corrections

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