Purpose

This study aims to provide a comprehensive review of the clinical benefits, complications, and safety profile associated with preoperative embolization in Glomus jugulare tumors (GJTs).

Materials and Methods

A comprehensive search in PubMed, Embase, and Web of Science was conducted for English articles published up to March 2023, focusing on GJTs and preoperative embolization. Included studies involved patients over 18 with GJTs. We excluded studies that explored embolization methods other than the standard endovascular approach, as well as studies involving paragangliomas that did not provide specific data related to GJTs. Key variables such as hemorrhage volume and surgical time, as well as clinical outcomes, were analyzed. Data were analyzed using a random-effects model meta-analysis, assessing heterogeneity with the I² statistic.

Results

This review encompasses 19 studies with a total of 328 patients. The studies incorporated into our meta-analysis display considerable differences and inconsistencies in their data. The findings of the meta-analysis show a mean hemorrhage volume of 636 ml (95% confidence interval (CI) 473–799) following preoperative embolization, and a mean surgical duration of 487 min (95% CI 350–624). The study also notes potential complications: facial nerve deficits occurred in 20% of cases (95% CI 11–32%), and vagal nerve deficits in 22% (95% CI 13–31%).

Conclusion

This study suggests that preoperative embolization could decrease surgery duration and blood loss, but emphasizes the importance of evaluating risks like nerve damage. However, the generalizability of these findings is restricted due to the diversity of available data.

Graphical Abstract

中文翻译：

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颈静脉瘤术前栓塞的疗效和安全性：临床结果和并发症的系统回顾和荟萃分析

目的

本研究旨在对颈静脉球瘤 (GJT) 术前栓塞相关的临床获益、并发症和安全性进行全面综述。

材料和方法

对 PubMed、Embase 和 Web of Science 中截至 2023 年 3 月发表的英文文章进行了全面检索，重点关注 GJT 和术前栓塞。纳入的研究涉及 18 岁以上接受 GJT 治疗的患者。我们排除了探索标准血管内方法以外的栓塞方法的研究，以及涉及未提供与 GJT 相关的具体数据的副神经节瘤的研究。分析了出血量和手术时间以及临床结果等关键变量。使用随机效应模型荟萃分析对数据进行分析，并使用 I ²统计量评估异质性。

结果

该综述涵盖 19 项研究，总共 328 名患者。纳入我们荟萃分析的研究显示其数据存在相当大的差异和不一致。荟萃分析结果显示，术前栓塞后平均出血量为 636 毫升（95% 置信区间 (CI) 473-799），平均手术时间为 487 分钟（95% CI 350-624）。该研究还指出了潜在的并发症：20% 的病例出现面神经缺陷（95% CI 11-32%），22% 的病例出现迷走神经缺陷（95% CI 13-31%）。

结论

这项研究表明，术前栓塞可以减少手术时间和失血量，但强调评估神经损伤等风险的重要性。然而，由于可用数据的多样性，这些发现的普遍性受到限制。

图形概要