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Neuroradiologische Diagnostik und Interventionen bei Prozessen an der Schädelbasis

Neuroradiologic diagnostic and interventional procedures for diseases of the skull base

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Zusammenfassung

In der Zusammenarbeit mit der Kopf-Hals-Chirurgie liegt neben der bildgesteuerten Gewebeentnahme ein besonderer neuroradiologischer Schwerpunkt in gefäßerhaltenden und gefäßverschließenden Maßnahmen. Hierbei ist die Kenntnis „gefährlicher“ Anastomosen zwischen extra- und intrakraniellen Gefäßen entscheidend. Es werden grundlegende Prinzipien der gefäßverschließenden Maßnahmen einschließlich der verwendeten Materialien vorgestellt und anhand von Fallbeispielen erläutert. Neben Embolisationen von Glomustumoren werden Behandlungsverfahren bei Epistaxis und zur präoperativen Okklusion der A. carotis interna vorgestellt. Ebenso werden gefäßerhaltende Behandlungen wie die Einbringung „gecoverter“ Stents zur Verbesserung der Resektabilität bei gefäßinfiltrierenden Tumoren oder nach iatrogener Verletzung der A. carotis interna im Rahmen von Schädelbasisoperationen erläutert.

Abstract

Besides image-guided biopsy techniques, the emphasis in the interdisciplinary cooperation between head and neck surgery and neuroradiology is on vessel-occluding and preserving measures. Knowledge of dangerous anastomoses between extracranial and intracranial vessels is crucial. The principles of vessel-occluding procedures including materials are presented and illustrated with case examples. Embolization of glomus tumors or epistaxis and preoperative permanent vessel occlusion techniques are demonstrated as well as vessel-preserving therapies, such as placement of covered stents for improving tumor resectability or after iatrogenic laceration of the internal carotid artery.

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  1. Institut für Diagnostische und Interventionelle Radiologie, Medizinische Fakultät, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    S. Macht & B. Turowski

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  1. S. Macht
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  2. B. Turowski
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Correspondence to S. Macht.

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Macht, S., Turowski, B. Neuroradiologische Diagnostik und Interventionen bei Prozessen an der Schädelbasis. HNO 59, 340–349 (2011). https://doi.org/10.1007/s00106-011-2283-2

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