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Perioperative Nursing of Balloon Occlusion Test and Embolization of Internal Carotid Artery for Locally Recurrent Nasopharyngeal Carcinoma

Received: 9 October 2022     Accepted: 2 November 2022     Published: 11 November 2022
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Abstract

Background: Surgical resection is the most effective treatment for the patients with locally recurrent nasopharyngeal carcinoma (NPC) in selected cases. Due to the complicated anatomical structure of nasopharynx, surgical resection may cause serious complications, including fatal bleeding. The subsequent implementation of internal carotid artery (ICA) embolization following a negative result of balloon occlusion test (BOT) can effectively reduce the risks of massive hemorrhage caused by the tumor or surgical management of the tumor. Objective: To explore the feasibility of perioperative nursing management for the patients with locally recurrent NPC underwent BOT and ICA embolization. Materials and Methods: This retrospective study investigated 81 locally recurrent NPC patients, who underwent BOT with or without following ICA embolization. Perioperative nursing management was performed for each case. In particular, close observations were conducted for the signs of brain function including consciousness, pupil size, vision, verbal ability, cognition, memory, limb movement, muscle strength, in comparison with the corresponding records before BOT. The positive or negative tested results of BOT, as well as the complications of BOT and ICA embolization were analyzed. The following nasopharyngeal surgeries was recorded. Results: A total of 82 BOTs were performed in 81 patients, including bilateral BOT in 1 case. The negative rate of BOT was 88.3% (76 of 82), which supported the option of ICA embolization procedure. After BOT, 75 patients underwent the following ICA embolization without neurological complications. Among them, 57 patients (76.0%) underwent subsequent salvage surgery to remove nasopharyngeal tumors without the occurrence of massive bleeding. The other 18 patients (24.0%) did not undergo salvage surgery due to tumor progression. Conclusion: Sequential implementation of BOT and ICA embolization reduced the risk of fatal bleeding during nasopharyngeal surgery, providing an opportunity for surgical treatment of locally recurrent NPC. Strict perioperative nursing management contributed to the successful treatment outcome.

Published in American Journal of Nursing Science (Volume 11, Issue 5)
DOI 10.11648/j.ajns.20221105.16
Page(s) 158-162
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Nasopharyngeal Carcinoma, Balloon Occlusion Test, Embolization, Nursing

References
[1] Fu, Z. T., et al., [Incidence and mortality of nasopharyngeal carcinoma in China, 2014]. Zhonghua Zhong Liu Za Zhi, 2018. 40 (8): p. 566-571.
[2] Lee, V., et al., Palliative systemic therapy for recurrent or metastatic nasopharyngeal carcinoma - How far have we achieved? Crit Rev Oncol Hematol, 2017. 114: p. 13-23.
[3] Kong, F., et al., Long-term survival and late complications of intensity-modulated radiotherapy for recurrent nasopharyngeal carcinoma. BMC Cancer, 2018. 18 (1): p. 1139.
[4] Lee, A. W. M., et al., Management of locally recurrent nasopharyngeal carcinoma. Cancer Treat Rev, 2019. 79: p. 101890.
[5] American Society of, I. and N. Therapeutic, Carotid artery balloon test occlusion. AJNR Am J Neuroradiol, 2001. 22 (8 Suppl): p. S8-9.
[6] Odderson, I. R., The National Institutes of Health Stroke Scale and its importance in acute stroke management. Phys Med Rehabil Clin N Am, 1999. 10 (4): p. 787-800, vii.
[7] Liu, J., et al., Salvage endoscopic nasopharyngectomy for local recurrent or residual nasopharyngeal carcinoma: a 10-year experience. Int J Clin Oncol, 2017. 22 (5): p. 834-842.
[8] Bossi, P., et al., Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up (dagger). Ann Oncol, 2021. 32 (4): p. 452-465.
[9] Chen, Y. P., et al., Chemotherapy in Combination With Radiotherapy for Definitive-Intent Treatment of Stage II-IVA Nasopharyngeal Carcinoma: CSCO and ASCO Guideline. J Clin Oncol, 2021. 39 (7): p. 840-859.
[10] Wu, L. R., et al., Validation of the 8th edition of AJCC/UICC staging system for nasopharyngeal carcinoma: Results from a non-endemic cohort with 10-year follow-up. Oral Oncol, 2019. 98: p. 141-146.
[11] Wei, W. I. and D. L. Kwong, Current management strategy of nasopharyngeal carcinoma. Clin Exp Otorhinolaryngol, 2010. 3 (1): p. 1-12.
[12] Han, F., et al., Long-term outcomes and prognostic factors of re-irradiation for locally recurrent nasopharyngeal carcinoma using intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol), 2012. 24 (8): p. 569-76.
[13] Yang, R., et al., Balloon Test Occlusion of Internal Carotid Artery in Recurrent Nasopharyngeal Carcinoma Before Endoscopic Nasopharyngectomy: A Single Center Experience. Front Oncol, 2021. 11: p. 674889.
[14] Zou, X., et al., A curative-intent endoscopic surgery for postradiation nasopharyngeal necrosis in patients with nasopharyngeal carcinoma. Cancer Commun (Lond), 2018. 38 (1): p. 74.
[15] Sorteberg, A., et al., Angiographic balloon test occlusion and therapeutic sacrifice of major arteries to the brain. Neurosurgery, 2008. 63 (4): p. 651-60; dicussion 660-1.
[16] Mathis, J. M., et al., Temporary balloon test occlusion of the internal carotid artery: experience in 500 cases. AJNR Am J Neuroradiol, 1995. 16 (4): p. 749-54.
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  • APA Style

    Wei Huang, Liantian Zhang, Litao Li, Yangkui Gu, Mengxuan Zuo. (2022). Perioperative Nursing of Balloon Occlusion Test and Embolization of Internal Carotid Artery for Locally Recurrent Nasopharyngeal Carcinoma. American Journal of Nursing Science, 11(5), 158-162. https://doi.org/10.11648/j.ajns.20221105.16

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    ACS Style

    Wei Huang; Liantian Zhang; Litao Li; Yangkui Gu; Mengxuan Zuo. Perioperative Nursing of Balloon Occlusion Test and Embolization of Internal Carotid Artery for Locally Recurrent Nasopharyngeal Carcinoma. Am. J. Nurs. Sci. 2022, 11(5), 158-162. doi: 10.11648/j.ajns.20221105.16

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    AMA Style

    Wei Huang, Liantian Zhang, Litao Li, Yangkui Gu, Mengxuan Zuo. Perioperative Nursing of Balloon Occlusion Test and Embolization of Internal Carotid Artery for Locally Recurrent Nasopharyngeal Carcinoma. Am J Nurs Sci. 2022;11(5):158-162. doi: 10.11648/j.ajns.20221105.16

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  • @article{10.11648/j.ajns.20221105.16,
      author = {Wei Huang and Liantian Zhang and Litao Li and Yangkui Gu and Mengxuan Zuo},
      title = {Perioperative Nursing of Balloon Occlusion Test and Embolization of Internal Carotid Artery for Locally Recurrent Nasopharyngeal Carcinoma},
      journal = {American Journal of Nursing Science},
      volume = {11},
      number = {5},
      pages = {158-162},
      doi = {10.11648/j.ajns.20221105.16},
      url = {https://doi.org/10.11648/j.ajns.20221105.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20221105.16},
      abstract = {Background: Surgical resection is the most effective treatment for the patients with locally recurrent nasopharyngeal carcinoma (NPC) in selected cases. Due to the complicated anatomical structure of nasopharynx, surgical resection may cause serious complications, including fatal bleeding. The subsequent implementation of internal carotid artery (ICA) embolization following a negative result of balloon occlusion test (BOT) can effectively reduce the risks of massive hemorrhage caused by the tumor or surgical management of the tumor. Objective: To explore the feasibility of perioperative nursing management for the patients with locally recurrent NPC underwent BOT and ICA embolization. Materials and Methods: This retrospective study investigated 81 locally recurrent NPC patients, who underwent BOT with or without following ICA embolization. Perioperative nursing management was performed for each case. In particular, close observations were conducted for the signs of brain function including consciousness, pupil size, vision, verbal ability, cognition, memory, limb movement, muscle strength, in comparison with the corresponding records before BOT. The positive or negative tested results of BOT, as well as the complications of BOT and ICA embolization were analyzed. The following nasopharyngeal surgeries was recorded. Results: A total of 82 BOTs were performed in 81 patients, including bilateral BOT in 1 case. The negative rate of BOT was 88.3% (76 of 82), which supported the option of ICA embolization procedure. After BOT, 75 patients underwent the following ICA embolization without neurological complications. Among them, 57 patients (76.0%) underwent subsequent salvage surgery to remove nasopharyngeal tumors without the occurrence of massive bleeding. The other 18 patients (24.0%) did not undergo salvage surgery due to tumor progression. Conclusion: Sequential implementation of BOT and ICA embolization reduced the risk of fatal bleeding during nasopharyngeal surgery, providing an opportunity for surgical treatment of locally recurrent NPC. Strict perioperative nursing management contributed to the successful treatment outcome.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Perioperative Nursing of Balloon Occlusion Test and Embolization of Internal Carotid Artery for Locally Recurrent Nasopharyngeal Carcinoma
    AU  - Wei Huang
    AU  - Liantian Zhang
    AU  - Litao Li
    AU  - Yangkui Gu
    AU  - Mengxuan Zuo
    Y1  - 2022/11/11
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ajns.20221105.16
    DO  - 10.11648/j.ajns.20221105.16
    T2  - American Journal of Nursing Science
    JF  - American Journal of Nursing Science
    JO  - American Journal of Nursing Science
    SP  - 158
    EP  - 162
    PB  - Science Publishing Group
    SN  - 2328-5753
    UR  - https://doi.org/10.11648/j.ajns.20221105.16
    AB  - Background: Surgical resection is the most effective treatment for the patients with locally recurrent nasopharyngeal carcinoma (NPC) in selected cases. Due to the complicated anatomical structure of nasopharynx, surgical resection may cause serious complications, including fatal bleeding. The subsequent implementation of internal carotid artery (ICA) embolization following a negative result of balloon occlusion test (BOT) can effectively reduce the risks of massive hemorrhage caused by the tumor or surgical management of the tumor. Objective: To explore the feasibility of perioperative nursing management for the patients with locally recurrent NPC underwent BOT and ICA embolization. Materials and Methods: This retrospective study investigated 81 locally recurrent NPC patients, who underwent BOT with or without following ICA embolization. Perioperative nursing management was performed for each case. In particular, close observations were conducted for the signs of brain function including consciousness, pupil size, vision, verbal ability, cognition, memory, limb movement, muscle strength, in comparison with the corresponding records before BOT. The positive or negative tested results of BOT, as well as the complications of BOT and ICA embolization were analyzed. The following nasopharyngeal surgeries was recorded. Results: A total of 82 BOTs were performed in 81 patients, including bilateral BOT in 1 case. The negative rate of BOT was 88.3% (76 of 82), which supported the option of ICA embolization procedure. After BOT, 75 patients underwent the following ICA embolization without neurological complications. Among them, 57 patients (76.0%) underwent subsequent salvage surgery to remove nasopharyngeal tumors without the occurrence of massive bleeding. The other 18 patients (24.0%) did not undergo salvage surgery due to tumor progression. Conclusion: Sequential implementation of BOT and ICA embolization reduced the risk of fatal bleeding during nasopharyngeal surgery, providing an opportunity for surgical treatment of locally recurrent NPC. Strict perioperative nursing management contributed to the successful treatment outcome.
    VL  - 11
    IS  - 5
    ER  - 

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Author Information
  • Department of Minimally Invasive Interventional, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China

  • Department of Minimally Invasive Interventional, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China

  • Department of Minimally Invasive Interventional, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China

  • Department of Minimally Invasive Interventional, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China

  • Department of Minimally Invasive Interventional, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, P. R. China

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