2017-18 HSC Section 3 Green Book

Otolaryngology–Head and Neck Surgery 153(6)

Table 1. Included Primary Studies and Characteristics of Relevant Data Available for Analysis.

Embolized

Nonembolized

Operative Time, min a

Patients (Tumors), n

Operative Time, min a

Patients (Tumors), n

Patients (Tumors), n EBL, mL a

EBL, mL a

Study

Year

Ward et al 22

1988 16 (17) 1991 17 (17) 1996 21 (22) 1997 20 (27) 2000 28 (28) 2001 39 (39) 2007 20 (25) 2006 17 (17) 2008 52 (57) 2008 14 (14) 2009 9 (9) 2010 8 (8) 2010 62 (66) 2010 13 (13) 2010 25 (25) 2011 20 (20) 2012 98 (104) 2012 7 (7) 2012 46 (48) 2012 29 (29) 2013 5 (5) 2013 12 (12)

6 (6)

397 (100-800) 105 (45-210)

10 (11)

1375 (250-3500) 280.2 (150-420)

Lamuraglia et al 14

373 6 213

609 6 564 764 6 588

11 (11) 11 (11)

— 6 (6)

—

Litle et al 6

1123 6 1450 306 6 150 588 (65-1800) 204 (100-330)

234 6 96

10 (11) 11 (15)

Tikkakoski et al 19 Wang et al 20 Plukker et al 29 Kasper et al 13 Makeieff et al 30 Ozay et al 18 Arnold et al 11 Gemmete et al 24 Liu et al 17

9 (12)

1374 (100-4500) 855 (100-3500) 750 (50-4600)

288 (80-545)

17 (17)

625 (50-3200)

— 11 (11) — 39 (39) — 10 (12) — 11 (11) — 52 (57) — 9 (9)

—

0

—

174 (90-450)

365 6 180 238 (80-400)

360 6 101

10 (13)

— — — —

6 (6)

600 (100-1000) 174 (100-248)

0

—

372 6 150

411 6 344

5 (5) 4 (4) 8 (8)

150

127

5 (5)

700

180

406 (50-1650)

— 0

—

—

Li et al 15

354.8 6 334.4 170.3 6 75.4 29 (30)

656.4 6 497.4 224.6 6 114

33 (36)

Lim et al 16

7 (7)

400 (200-1200) 360 (180-540)

6 (6)

550 (200-1400) 265.6 (40-90) 710 (250-1650)

360 (220-480)

Zeitler et al 4

10 (10)

305 (50-1000) 415 (230-850)

— 15 (15) — 16 (16) — 69 (71)

— — — —

Avgerinos et al 12

4 (4)

Power et al 7 Shah et al 26

263 6 250 55 (15-80)

599 6 265

29 (33)

7 (7)

— 0

—

Zeng et al 31 (F) b

1260 6 1256

255 6 69 227 6 91

0 0

— —

— 5 (5) — 41 (43)

Zeng et al 31 (NF) b 2012 46 (48)

773 6 727

Zhang et al 21

21 (21)

280 (50-850) 180 (160-220) 327 (40-1400) 148 (35-289)

8 (8)

450 (100-1000)

220 (170-260)

Abdel-Aziz et al 23

5 (5)

0

— —

— —

Kalani et al 25

12 (12)

191.6 (25-600)

— 0

Abbreviation: EBL, estimated blood loss. a Mean 6 SD or mean (range). b Zeng et al 31 divided their study into functional (F) and nonfunctional (NF) tumors based on catecholamine secretion. Therefore, their study represents 2 rows, since they did not provide data for the overall study population.

Figure 2. Forest plot comparing estimated blood loss for patients embolized and not embolized preoperatively, favoring preoperative embolization to decrease estimated blood loss during carotid body paraganglioma excision. CI, confidence interval; IV, inverse variance.

performed within 24 to 48 hours preoperatively, and the pooled analysis was in favor of embolization (SMD = –0.55; 95% CI: –0.81, –0.30). Wang et al 20 did not differentiate by embolization technique, and they showed no difference between embolization and no embolization for the outcome of EBL (SMD = –0.24; 95% CI: –1.00, 0.52; test of interaction, P = .45). All 6 studies

with useful data for operative time were based on transarterial embolization; thus, no comparison could be made between transarterial and transcutaneous techniques.

Tumor size. Of the 12 studies included for the outcome of EBL, 7 reported tumor size. There was no significant

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