Protective Surgical Procedures for Carotid Body Tumors: A Case Series

Toktaş, Faruk; Yümün, Gündüz; Gücü, Arif; Goncu, Tugrul; Eris, Cuneyt; Cayir, Cagdas; As, Kagan; Yavuz, Şenol

doi:10.5152/etd.2013.65

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…It is a reddish-brown, well circumscribed, highly specialized round organ, 2-6 mm in size, located in the adventitia of the carotid bifurcation, supplied by the feeding vessels run primarily from the ascending pharyngeal branch of the external carotid artery, and innervated through the glossopharyngeal and vagus nerves. It functions as a chemoreceptor organ which is stimulated by acidosis, hypoxia and hypercapnea, and plays a role in the autonomous control of blood pressure, heart rate, respiration, and blood temperature in response to changes in these parameters by increasing sympathetic flow [4,6,7]. for patients who cannot undergo surgery on account of extensive involvement, multiple tumors, and high operative and anesthetic risk [18].…”

Section: Discussionmentioning

confidence: 99%

Carotid body tumors: A report of three cases and current literature review

Müdüroğlu¹,

Yuksel²

2017

Vascul Dis Ther

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Carotid body tumors are rare, slow-growing, hypervascular neuroendocrine tumors. Although these tumors are benign neoplasm, they also have a tendency to malignant transformation. Complete surgical excision is the gold standard therapeutic modality for the treatment of carotid body tumors. Early surgical removal is recommended to prevent the development of larger and more advanced tumors, which are associated with higher morbidity and mortality. In this report, we presented three cases of carotid body tumor which were successfully treated with complete surgical excision, and reviewed the current literature. Furthermore, it was emphasized the necessity of early surgical management regardless of patient age and tumor size.

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Section: Discussionmentioning

confidence: 99%

Carotid body tumors: A report of three cases and current literature review

Müdüroğlu¹,

Yuksel²

2017

Vascul Dis Ther

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“…The embryologic origin is from the third branchial arch and contains homeostatic chemoreceptor cells-the sensory nerve endings of the carotid sinus nerve penetrate the clusters to synapse with chemoreceptor cells [31][32][33][34][35][36][37]. The carotid body is made up of two types of cells, called glomus cells: glomus type I cells derived from the neural crest, and glomus type II cells and act as supporting cells [38][39][40][41][42][43][44][45][46][47]. The glomus or type I cells of the CB are the transducers of hypoxic stimuli, and relay chemosensory information to the brainstem via neurotransmitter release at synaptic contacts with afferent terminals of the carotid sinus nerve.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of cranial nerve palsy as a complication of CBT surgery has been reported to range from 10% to 40% [5,15,41]. The use of clamping of all carotid arteries with placement of shunt and the immediate replacement or repair of damaged vessel, can reduce clearly massive bleeding, cerebrovascular accidents and overall morbidity [44].…”

Section: Treatment Optionsmentioning

confidence: 99%

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Surgical Resection of Painless Carotid Body Tumour without Preoperative Embolization: A Case Report and Review of Literature

Cimpean¹,

Belhaj²,

Rondelet³

2017

J Clin Case Rep

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Paragangliomas are rare tumors representing a therapeutic challenge. We present a case report of surgical resection of carotid body tumor without preoperative embolization. Our therapeutic attitude is based on controversial benefits of the embolization for those tumors. The major indication for the preoperative embolization is to reduce intraoperative blood loss, but this benefit is not demonstrated. Also, because the relative rarity of this tumor, the confounding factors relative to the surgeon and radiologist experience, no randomized trial can be performed. So, our case report can be useful to participate to increase the number of reported cases, and define the therapeutic approach for this rare tumor.

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“…However in some cases cited in the literature local, and regional anesthesia were applied. In a series consisting of 4 cases reported by Toktas et al local anesthesia had been used, and any surgical complication was not seen [10]. In the literature a case with CBT operated under cervical plexus block has been reported [11].…”

Section: Discussionmentioning

confidence: 99%

Anesthetic considerations for carotid body tumors surgery

Kavakli

Öztürk

2016

North Clin Istanbul

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OBJECTIVE:Carotid body tumors (CBT) are benign tumors that originate from neural non-chromaffin cells that are typically localized near carotid bifurcation. Surgical removal of the tumor is the most appropriate treatment. General anesthesia is preferred anesthetic technique for CBT surgery. Basic elements of anesthetic management are protection of hemodynamic stability and maintaining cerebral perfusion pressure (CPP). The aim of this study was to evaluate anesthetic management of CBT surgery and present the literature knowledge.METHODS:The study included 10 consecutive patients with diagnosis of CBT who underwent surgery at Antalya Training and Research Hospital, in Antalya, Turkey, between 2013 and 2016. Preoperative demographic details; comorbidities; side of surgical site; duration of operation; length of intensive care unit (ICU) and hospital stay; change of intraoperative blood pressure; use of inotropic drugs, blood products, and analgesics; postoperative visual analogue scale (VAS) pain score; and complications were recorded.RESULTS:According to Shamblin classification, 3 tumors were type I and the remaining 7 were type II. Tumors were located on right side in 6 patients, and on left in 4. Blood loss sufficient to require transfusion was observed in 1 patient. Average intraoperative blood loss was 287±68 mL. Tachycardia and hypertension were observed in 1 patient; bradycardia and hypotension were seen in 4 patients. Infusion for inotropic support was administered to 1 patient. Mean duration of operation was 109±20 minutes. Mean VAS score was 4±1, mean ICU tramadol consumption was 80±25 mg. Duration of stay in ICU and hospital were 2.4±1.1 hours and 3.8±0.7 days, respectively. Mortality and neurological complications were not seen in postoperative period.CONCLUSION:CBT surgery requires close and complex anesthesia management. Protection of hemodynamic stability against sudden hemodynamic changes, monitoring, and maintaining CPP are the most important aspects of anesthetic management.

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Protective Surgical Procedures for Carotid Body Tumors: A Case Series

Cited by 4 publications

References 13 publications

Carotid body tumors: A report of three cases and current literature review

Carotid body tumors: A report of three cases and current literature review

Surgical Resection of Painless Carotid Body Tumour without Preoperative Embolization: A Case Report and Review of Literature

Anesthetic considerations for carotid body tumors surgery

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