Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (2): 21-25.doi: 10.6040/j.issn.1673-3770.0.2019.071

• Invited Review • Previous Articles     Next Articles

Protection of the internal carotid artery during surgery for nasopharyngeal carcinoma

Zhenlin WANG*(),Junqi LIU   

  1. Department of Otolaryngology Head and Neck Surgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China
  • Received:2019-02-20 Online:2019-03-20 Published:2019-03-28
  • Contact: Zhenlin WANG E-mail:wzl1812@163.com

Abstract:

Internal carotid artery bleeding is a common complication during or after surgery for nasopharyngeal carcinoma and may result in hemiplegia or death. Internal carotid artery bleeding can also occur after radiotherapy. Prevention and management of this complication are of utmost importance for patient survival and quality of life. This article reviews the recent advances and reports our experience in the management of internal carotid artery bleeding. We also discuss the surgical options for extended resection of the tumor.

Key words: Nasopharyngeal neoplasms, Complications, Internal carotid artery bleeding

CLC Number: 

  • R765

Table 1

Surgical efficacy of relapsed patients"

作者 发表年 例数 3年/5年
生存率(%)
3年/5年
局控率(%)
邱前辉等[7] 2017 45 81.0/76.0
孙希才等[8] 2015 71 63.0/39.0 50.5/31.9
司勇锋等[9] 2010 46 -/72.0
Vlantis等[10] 2007 79 -/51.0 -/62.0
唐平章等[11] 2005 41 -/34.0
Wei等[12] 2003 109 -/54.0 -/69.0
King等[13] 2002 31 -/47.0 -/71.0
Hsu等[14] 2001 60 -/30.0 -/48.3
1 Wei KR , Zheng RS , Zhang SW , et al. Nasopharyngeal carcinoma incidence and mortality in China in 2010[J]. Chin J Cancer, 2014, 33 (8): 381- 387.
doi: 10.5732/cjc.014.10086
2 文译辉, 文卫平. 经鼻内镜对局部残留和复发鼻咽癌的手术切除[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24 (23): 1095- 1098.
doi: 10.3969/j.issn.1001-1781.2010.23.018
3 Xiao WW , Han F , Lu TX , et al. Treatment outcomes after radiotherapy alone for patients with early-stage nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys, 2009, 74 (4): 1070- 1076.
doi: 10.1016/j.ijrobp.2008.09.008
4 Bian XH , Song T , Wu SX . Outcomes of xerostomia-related quality of life for nasopharyngeal carcinoma treated by IMRT: based on the EORTC QLQ-C30 and H &N35 questionnaires[J]. Expert Rev Anticancer Ther, 2015, 15 (1): 109- 119.
doi: 10.1586/14737140.2015.961427
5 Zhao CL , Chen J , Yu B , et al. Improvement in quality of life in patients with nasopharyngeal carcinoma treated with non-invasive extracorporeal radiofrequency in combination with chemoradiotherapy[J]. Int J Radiat Biol, 2014, 90 (10): 853- 858.
doi: 10.3109/09553002.2014.916579
6 Cao SM , Simons MJ , Qian CN . The prevalence and prevention of nasopharyngeal carcinoma in China[J]. Chin J Cancer, 2011, 30 (2): 114- 119.
doi: 10.5732/cjc.010.10377
7 邱前辉, 李娜, 张秋航, 等. 内镜手术治疗首诊局部晚期鼻咽癌的疗效分析[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52 (5): 365- 371.
doi: 10.3760/cma.j.issn.1673-0860.2017.05.009
QIU Qianhui , LI Na , ZHANG Qiuhang , et al. Clinical efficacy of endoscopic nasopharyngectomy for initially diagnosed advanced nasopharyngeal carcinoma[J]. Chinese JOurnal of Otorhinolaryngology Head and Neck Surgery, 2017, 52 (5): 365- 371.
doi: 10.3760/cma.j.issn.1673-0860.2017.05.009
8 孙希才, 刘娟, 王欢, 等. 内镜下复发性鼻咽癌71例切除及预后分析[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50 (11): 890- 895.
doi: 10.3760/cma.j.issn.1673-0860.2015.11.003
SUN Xicai , LIU Juan , WANG Huan , et al. Endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma: a review of 71 patients and analysis of the prognostic factors[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2015, 50 (11): 890- 895.
doi: 10.3760/cma.j.issn.1673-0860.2015.11.003
9 覃扬达, 司勇锋, 张政, 等. 鼻咽癌治疗后颈转移灶残留或复发的再治疗[J]. 中国耳鼻咽喉头颈外科, 2010, 17 (7): 337- 339.
doi: 10.16066/j.1672-7002.2010.07.022
QIN Yangda , SI Yongfeng , ZHANG Zheng , et al. Re-treatment of residual/recurrent cervical metastasis after radiotherapy for nasopharyngeal carcinoma[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2010, 17 (7): 337- 339.
doi: 10.16066/j.1672-7002.2010.07.022
10 Vlantis AC , Tsang RKY , Yu BKH , et al. Nasopharyngectomy and surgical margin status[J]. Arch Otolaryngol Head Neck Surg, 2007, 133 (12): 1296.
doi: 10.1001/archotol.133.12.1296
11 孙燕, 赵平. 临床肿瘤学进展[M]. 北京: 中国协和医科大学出版社, 2005: 1028- 1929.
12 Wei WI . Cancer of the nasopharynx: functional surgical salvage[J]. World J Surg, 2003, 27 (7): 844- 848.
doi: 10.1007/s00268-003-7110-9
13 King WW , Ku PK , Mok CO , et al. Nasopharyngectomy in the treatment of recurrent nasopharyngeal carcinoma: a twelve-year experience[J]. Head Neck, 2000, 22 (3): 215- 222.
doi: 10.1002/(ISSN)1097-0347
14 Hsu MM , Hong RL , Ting LL , et al. Factors affecting the overall survival after salvage surgery in patients with recurrent nasopharyngeal carcinoma at the primary site: experience with 60 cases[J]. Arch Otolaryngol Head Neck Surg, 2001, 127 (7): 798- 802.
15 张秋航. 内镜鼻窦外科技术的延伸与进步[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44 (7): 532- 534.
doi: 10.3760/cma.j.issn.1673-0860.2009.07.002
ZHANG Qiuhang . Development and extension of endoscopic endonasal surgical technique[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2009, 44 (7): 532- 534.
doi: 10.3760/cma.j.issn.1673-0860.2009.07.002
16 张秋航. 内镜颅底外科实践中存在的问题[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53 (4): 241- 243.
doi: 10.3760/cma.j.issn.1673-0860.2018.04.001
ZHANG Qiuhang . The practical problems on endoscopic skull base surgery[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2018, 53 (4): 241- 243.
doi: 10.3760/cma.j.issn.1673-0860.2018.04.001
17 Wang ZL , Zhang QH , Li MC , et al. The impact of resection of skull base tumor via an endoscopic endonasal approach on the visual function of vision impaired patients and the analysis of factors affecting their visual recovery[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2018, 53 (4): 244- 250.
doi: 10.3760/cma.j.issn.1673-0860.2018.04.002
18 Zhang QH , Wang ZL , Guo HC , et al. Endoscopic approach to remove intra-extracranial tumors in various skull base regions: 10-year experience of a single center[J]. Chin Med J, 2017, 130 (24): 2933- 2940.
doi: 10.4103/0366-6999.220306
19 张秋航, 孔锋, 郭宏川, 等. 内镜经鼻径路治疗侵犯斜坡硬膜内外沟通型脊索瘤[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45 (7): 542- 546.
doi: 10.3760/cma.j.issn.1673-0860.2010.07.004
ZHANG Qiuhang , KONG Feng , GUO Hongchuan , et al. Nasal endoscopic resection of extended intradural clival chordoma[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2010, 45 (7): 542- 546.
doi: 10.3760/cma.j.issn.1673-0860.2010.07.004
20 张秋航.内镜径路侧颅底肿瘤的外科治疗[C]. 2015年全国鼻科年会暨第七届鼻部感染与变态反应疾病专题学术会议.2015.
21 王卫东, 孙宏亮, 骆江红, 等. 覆膜支架腔内修复治疗颈动脉假性动脉瘤破裂出血[J]. 介入放射学杂志, 2017, 26 (1): 15- 19.
doi: 10.3969/j.issn.1008-794X.2017.01.004
WANG Weidong , SUN Hongliang , LUO Jianghong , et al. Endovascular repair with covered stent for the treatment of ruptured carotid artery pseudoaneurysms[J]. Journal of Interventional Radiology, 2017, 26 (1): 15- 19.
doi: 10.3969/j.issn.1008-794X.2017.01.004
22 李慎茂, 凌锋, 缪中荣, 等. 颈动脉狭窄血管内支架治疗并发症的临床分析[J]. 中国脑血管病杂志, 2005, 2 (2): 56- 61.
doi: 10.3969/j.issn.1672-5921.2005.02.003
LI Shenmao , LING Feng , MIAO Zhongrong , et al. Analysis of complications in percutaneous transluminal stenting for stenosis of internal carotid artery[J]. Chinese Journal of Cerebrovascular Diseases, 2005, 2 (2): 56- 61.
doi: 10.3969/j.issn.1672-5921.2005.02.003
23 聂本津, 缪中荣, 焦力群, 等. 颈动脉支架置入术后高灌注综合征与侧支循环的临床分析[J]. 中国脑血管病杂志, 2009, 6 (5): 263- 266.
doi: 10.3969/j.issn.1672-5921.2009.05.009
NIE Benjin , MIAO Zhongrong , JIAO Liqun , et al. Clinical study on relationship of hyperperfusion syndrome and coll-ateral circulation following carotid artery stenting[J]. Chinese Journal of Cerebrovascular Diseases, 2009, 6 (5): 263- 266.
doi: 10.3969/j.issn.1672-5921.2009.05.009
24 黎劭学, 陈锦华, 黄胜平. 球囊闭塞试验的适应证以及相关并发症的预防[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46 (4): 350- 352.
doi: 10.3760/cma.j.issn.1673-0860.2011.04.024
25 邱明国, 张绍祥, 刘正津, 等. 咽鼓管区薄层断层解剖学研究[J]. 解剖学杂志, 2002, 25 (1): 10- 14.
doi: 10.3969/j.issn.1001-1633.2002.01.003
26 Wen YH , Wen WP , Chen HX , et al. Endoscopic nasopharyngectomy for salvage in nasopharyngeal carcinoma: A novel anatomic orientation[J]. The Laryngoscope, 2010, 120 (7): 1298- 1302.
doi: 10.1002/lary.20958
27 Becker AM , Hwang PH . Endoscopic endonasal anatomy of the nasopharynx in a cadaver model[J]. Int Forum Allergy Rhinol, 2013, 3 (4): 319- 324.
doi: 10.1002/alr.21104
28 陈锐聪, 邹志敏, 蔡军, 等. 应用Hybrid手术室颅内外血管搭桥联合血管介人治疗颈内动脉受侵犯的鼻咽癌[J]. 广东医学, 2018, 39 (6): 960.
doi: 10.3969/j.issn.1001-9448.2018.06.039
[1] LU Zhaoyang, ZHAI Zhaoxue, WANG Huikang, SHAO Liting, ZHANG Yu. COVID-19 treatment-induced diabetic ketoacidosis combined with rhino-orbital cerebral mucormycosis: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 90-94.
[2] MA Xin, DONG Lingkang, WU Hongmin, YI Hongliang, ZOU Jianyin. Modifications and applications of lateral expansion abduction suspension suture technique in the treatment of obstructive sleep apnea [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 81-88.
[3] MA Li, GAO Zhan, LI Pengqi, NI Qianwei. Current status of anatomical research on nasal orbital ethmoid and concurrent zygomatic bone fracture complications [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 126-130.
[4] LI Hao, YANG Liyuan, ZHANG Shoukai. Short-term clinical observation of drugsustained-release stent implantation in patients with refractory sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 38-42.
[5] YUE Tao, ZHUANG Dayong, ZHOU Peng, LI Xiaolei, XU Jing, ZHU Jian, HE Qingqing. The complications of tracheal injury in da Vinci robotic thyroidectomy: four case reports and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 46-50.
[6] CHAI Lina, LEI Chunyan, GAO Sheng, ZHANG Meixia. Isolated congenital retinal arteriovenous malformation with vitreous hemorrhage and sub-inner limiting membrane hemorrhage:a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 67-70.
[7] LI Ying. Importance of standardized methods in corneal refractive surgery and the prevention of complications [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 1-6.
[8] CIREN Qiongda, WU Yuan. A case of long-term ocular complications caused by toxic epidermal necrolysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 147-150.
[9] ZHAO Yaming, SHI Song. Three cases of diagnosis and treatment of cervical necrotizing fasciitis with a primary diagnosis of acute epiglottitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 12-16.
[10] SUN Chuan, LIU Yaqun, HE Shuangba, ZHANG Qingxiang. Cryogenic plasma-assisted nasal resection of seventeen cases of anterior and middle skull base tumors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 55-59.
[11] FANG Zhongju, ZHANG Yongxia, ZHAO Jiandong, ZONG Liang, ZHAI Xingyou, LI Xinjian, PENG Xin, REN Nan, CHEN Liwei, LIU Mingbo. Combined treatment of chylous leakage after lymph node dissection for thyroid cancer [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 64-68.
[12] SU Caipei, YANG Yabo. Surgical skills required for small incision lenticule extraction(SMILE), and the prevention and management of SMILE-related complications [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 13-16.
[13] ZHANG Chanyuan, SUN Yulin, WANG Lin, ZHANG Li, CHEN Min, YI Longgang, LI Na, CUI Xin, JIANG Yan. Clinical diagnosis and treatment of orbital complications following pediatric acute rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 34-40.
[14] WANG Panpan. Effects of a quality control circle-based discharge plan on rehabilitation after ear deformity reconstruction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 165-168.
[15] Yan JIANG. Recurrence of nasopharyngeal carcinoma and application of endoscopic surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 1-11.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!