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EMBOLISATION THERAPEUTIQUE EN PATHOLOGIE ORL. INDICATIONS ET RESULTATS

par Vincent, Y.;Broos, Joseph ;Gerard, Mage;Balériaux, Danielle
Référence Acta oto-rhino-laryngologica Belgica, 35, 3-4, page (247-261)
Publication Publié, 1981

Article révisé par les pairs

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Résumé :

The progress of therapeutic embolization in otolaryngology was made possible by the arrival of new techniques which allowed the embolization of the different branches of the arteria carotis externa. The embolization technique is based on two principles: 1) the embolus is to be injected in a super-selective way, after catheterization of the pathological blood vessels; and 2) the mass of the embolus has to be big enough to be able to obstruct the pathological vessel. Therefore the femoral route is mostly used. The aim of embolization is to create a spontaneous thrombosis around the used particles. The thrombosis thus succeeds in completing the embolization. The principal contra-indications against embolization are due to facts of a technical and a geographical order. Incidents and accidents are often related either to the catheterization, or to the contrast media, or to the anastomoses which become functional after the embolization. The major complications are hemiplegia, aphasia, and eyesight troubles, all problems brought about by ischemic lesions. The principal indications for embolization in otolaryngology are: - the indications for isolated embolization, among which the surgical contra-indications, severe epistaxis, vessel malformations, important cranio-facial angiomatosis, the telangiectasical family angiomatosis of Rendu-Osler, and the antalgic effect of embolization, in particular in cancer treatment, have to be pointed out; - another excellent indication for embolization is the prevention of massive hemorrhages and the simplification of the surgical act, in particular in hypervascularized ORL tumors, either benign or malignant, for instance the naso-pharyngeal fibroma and the whole of the malignant tumors and of the metastases of the ORL sphere. With skilled hands and the usual precautions, accidents in embolization are exceptional and embolization remains a therapeutic process with great prospects.