Abstract：
BACKGROUND: Jugular paragangliomas are highly vascularized tumors that can grow in challenging neurovascular compartments and are particularly challenging to resect. There is still no consensus whether preoperative embolization should be employed to minimize intraoperative morbidity.
METHODS: A systematic review and meta-analysis was conducted by searching PubMed, Web of Science, and Embase databases for key terms including \"embolization,\" \"jugular paragangliomas,\" and \"surgery.\"
RESULTS: This review included 25 studies with 706 patients and 475 (67%) preoperative embolizations. Polyvinyl alcohol particles were the most common embolic agent (97.8% of all patients who underwent embolization). Complication rate of embolization was 1% (95% confidence interval [CI]: 0%, 2%). Preoperative embolization was significantly associated with less intraoperative estimated blood loss (mean difference of -7.92 dL [95% CI: -9.31 dL, -6.53 dL]), shorter operating room times (mean difference of -55.24 minutes [95% CI: -77.10 minutes, -33.39 minutes]), and less overall tumor recurrence (odds ratio = 0.23 [95% CI: 0.06, 0.91]) compared with resective surgery alone. Preoperative embolization had no impact on the development of postoperative new cranial nerve deficits not associated with embolization (odds ratio = 1.17 [95% CI: 0.47, 2.91]) and achievement of gross total resection (odds ratio = 1.92 [95% CI: 0.67, 5.53]).
CONCLUSIONS: Preoperative embolization may provide surgical efficiency with faster surgical times and less bleeding and safety with diminished overall recurrence via safe embolization with minimal risks. These results must be considered taking into account the nonrandomness of studies.
METHODS: A systematic review and meta-analysis was conducted by searching PubMed, Web of Science, and Embase databases for key terms including \"embolization,\" \"jugular paragangliomas,\" and \"surgery.\"
RESULTS: This review included 25 studies with 706 patients and 475 (67%) preoperative embolizations. Polyvinyl alcohol particles were the most common embolic agent (97.8% of all patients who underwent embolization). Complication rate of embolization was 1% (95% confidence interval [CI]: 0%, 2%). Preoperative embolization was significantly associated with less intraoperative estimated blood loss (mean difference of -7.92 dL [95% CI: -9.31 dL, -6.53 dL]), shorter operating room times (mean difference of -55.24 minutes [95% CI: -77.10 minutes, -33.39 minutes]), and less overall tumor recurrence (odds ratio = 0.23 [95% CI: 0.06, 0.91]) compared with resective surgery alone. Preoperative embolization had no impact on the development of postoperative new cranial nerve deficits not associated with embolization (odds ratio = 1.17 [95% CI: 0.47, 2.91]) and achievement of gross total resection (odds ratio = 1.92 [95% CI: 0.67, 5.53]).
CONCLUSIONS: Preoperative embolization may provide surgical efficiency with faster surgical times and less bleeding and safety with diminished overall recurrence via safe embolization with minimal risks. These results must be considered taking into account the nonrandomness of studies.
摘要：
背景：颈静脉副神经节瘤是高度血管化的肿瘤，可以在具有挑战性的神经血管区室中生长，并且切除特别具有挑战性。是否应采用术前栓塞以最大程度地减少术中发病率，目前尚无共识。
方法：通过搜索PubMed，WebofScience,和Embase数据库的关键术语，包括“栓塞，颈静脉副神经节瘤,“和”手术。\"
结果：本综述包括25项研究，包括706例患者和475例（67%）术前栓塞。聚乙烯醇颗粒是最常见的栓塞剂（占所有栓塞患者的97.8％）。栓塞并发症率为1%(95%置信区间[CI]:0%,2%)。术前栓塞与术中估计失血减少显著相关(平均差异-7.92dL[95%CI:-9.31dL,-6.53dL])，较短的手术室时间(平均差异为-55.24分钟[95%CI：-77.10分钟，-33.39分钟]），与单纯切除手术相比,总体肿瘤复发率较低(比值比=0.23[95%CI:0.06,0.91])。术前栓塞对与栓塞无关的术后新的颅神经缺损的发展（比值比=1.17[95％CI：0.47，2.91]）和总切除的实现（比值比=1.92[95％CI：0.67，5.53]）没有影响。
结论：术前栓塞可以提供手术效率，具有更快的手术时间和更少的出血和安全性，并通过安全的栓塞以最小的风险减少总体复发。这些结果必须考虑到研究的非随机性。
方法：通过搜索PubMed，WebofScience,和Embase数据库的关键术语，包括“栓塞，颈静脉副神经节瘤,“和”手术。\"
结果：本综述包括25项研究，包括706例患者和475例（67%）术前栓塞。聚乙烯醇颗粒是最常见的栓塞剂（占所有栓塞患者的97.8％）。栓塞并发症率为1%(95%置信区间[CI]:0%,2%)。术前栓塞与术中估计失血减少显著相关(平均差异-7.92dL[95%CI:-9.31dL,-6.53dL])，较短的手术室时间(平均差异为-55.24分钟[95%CI：-77.10分钟，-33.39分钟]），与单纯切除手术相比,总体肿瘤复发率较低(比值比=0.23[95%CI:0.06,0.91])。术前栓塞对与栓塞无关的术后新的颅神经缺损的发展（比值比=1.17[95％CI：0.47，2.91]）和总切除的实现（比值比=1.92[95％CI：0.67，5.53]）没有影响。
结论：术前栓塞可以提供手术效率，具有更快的手术时间和更少的出血和安全性，并通过安全的栓塞以最小的风险减少总体复发。这些结果必须考虑到研究的非随机性。
