ИСТИНА

Background: Tumors of the neurovascular bundle in the neck are rare and difficult to treat formations, primarily due to complex topographic relationships with important structures of the neck. The approaches to their treatment are still largely unclear. Methods: The study included 53 patients who underwent a total of 55 surgical interventions performed between 2003 and 2021. We analysed clinical, topographic, radiological features of the lesions and technical aspects of the operations. During operations, neurophysiological monitoring of the function of the cranial nerves was carried out, as well as monitoring of the brain's tolerance to clamping of the carotid arteries when they were involved. Results: Histologically, paragagangliomas were found in 34 cases, neurinomas in 11 cases, and neurofibromas in 10 cases. Angiography with embolization of tumor vessels was performed in 24 cases before surgery. En-block tumor removal was achieved in 47% of cases. Total tumor resection was achieved in 76% (n=42), of which 28 were paragangliomas and 14 were neurinomas/neurofibromas. 11 tumors (20%) were removed subtotally: 4 paragangliomas and 7 neurinomas/neurofibromas. Partial tumor resection was achieved in two cases. Reconstruction or prosthesis of the brachiocephalic arteries was required in 7 cases in patients with paragangliomas of the carotid body and vagus nerve. In 53%, there was no increase in neurological deficit. In 20 cases (36%), a transient deterioration in the function of the cranial nerves was noted: in 5 patients with neurofibromas, 4 with neurinomas, and 11 with paragangliomas. Persistent neurological deficit was recorded in 6 cases (10%): in one patient with hypoglossal neurofibroma and in 5 cases in patients with paragangliomas. Conclusion: The choice of surgical treatment of benign formations of neurovascular bundle in the neck should be taken individually taking into account clinical, topographic features of the tumor and the involvement of carotid arteries.