[Therapeutic embolization in ORL pathology. Indications and results]

The progress of therapeutical embolization in otolaryngology was made possible by the arrival of new techniques which allowed the embolization of the different ramifications of the arteria carotis externa. The embolization technique is based on two principles: 1. The embolus is to be injected in a super-selective way, after catheterization of the pathological blood vessels. 2. The mass of the embolus has to be big enough to be able to obstruct the pathological vessel. Therefore the femoral way is mostly used. The aim of embolization is to create a spontaneous thrombosis around the used particles. The thrombosis thus succeeds in completing the embolization. The principal counter-indications against embolization are due to facts of a technical and a geographical order. Incidents and accidents are often related either to the catheterization, or to the contrast-media, or also to the anastomoses which become functional after the embolization. The major complications are hemiplegiae, aphasiae and eyesight troubles, all problems brought about by ischaemia are: --the indications for isolated embolization, amongst which have to be pointed out the surgical counter-indications, severe epistaxis, vessel malformations, important cranio-facial angiomatosis, the telangiectasical family angiomatosis of Rendu-Osler, and the antalgic effect of embolization, in particular in cancer treatment; -- an excellent indication for embolization is the prevention of massive hemorrhages and the simplification of the surgical act, in particular in hypervascularized ORL tumours, either benign or malignant, for instance the naso-pharyngeal fibrome and the whole of the malignant tumours and of the metastases of the ORL sphere. To conclude, we may say, that, within skilled hands and when taking the usual precautions, accidents in embolization are exceptional, and that embolization remains a therapeutical process with great prospects.