Background: Carotid body tumours (CBTs) are rare tumours that arise from chemoreceptor cells at the bifurcation of carotid artery. Excision of CBT poses several anesthetic challenges and may be complicated with marked...Background: Carotid body tumours (CBTs) are rare tumours that arise from chemoreceptor cells at the bifurcation of carotid artery. Excision of CBT poses several anesthetic challenges and may be complicated with marked intraoperative hemodynamic instability and turbulent postoperative recovery. Attention to details and a meticulous anesthetic plan are essential for successful anesthetic management. Aim: To present anaesthetic management and challenges for carotid body tumour excision in a young Nigerian. Case Presentation: A 26-year-old man presented with left sided slow growing neck tumour. The tumour was completely excised with no anaesthetic or surgical complication. Histology and immunohistochemistry of the excised tumour confirmed paraganglioma. He was discharged fifteenth post-operative day. Conclusion: General anesthesia is the preferred technique. The basic elements of anesthetic management are protection of hemodynamic stability and maintenance of cerebral perfusion pressure (CPP).展开更多
The carotid body is a small structure weighing 12 mg located in the adventitia of carotid artery bifurcation acting as a chemoreceptor. Carotid body tumour (CBT);formerly known as chemodectoma is a rare, highly vascul...The carotid body is a small structure weighing 12 mg located in the adventitia of carotid artery bifurcation acting as a chemoreceptor. Carotid body tumour (CBT);formerly known as chemodectoma is a rare, highly vascular, mostly benign tumour arising from the paraganglia of carotid body;hence, the name (carotid paraganglioma). The high vascularity and proximity to cranial nerves and major vessels make this tumour a surgical challenge. Abundant literature has been written about CBT in the last century with a continuous debate regarding its etiology, natural history, biological behavior, proper technique of excision, and the morbidity and mortality associated with its resection. The purpose of this review article is to simplify understanding the basic and clinical aspects of this challenging neoplasm.展开更多
Background: Carotid body tumour (CBT) is a rare neoplasm, yet it is the commonest head and neck paraganglioma. In Iraq, relevant literature is sparse. Herein, we present our second case series. Methodology: Patients w...Background: Carotid body tumour (CBT) is a rare neoplasm, yet it is the commonest head and neck paraganglioma. In Iraq, relevant literature is sparse. Herein, we present our second case series. Methodology: Patients with CBTs that were operated upon in the Department of Thoracic and Vascular Surgery, Baghdad Medical City from 2010 to 2014 were enrolled. History and examination were followed by a workup of duplex ultrasonography, CT scan, magnetic resonance imaging, CT or conventional carotid angiography. Surgical exploration via a standard anterolateral cervical incision and subadventitial dissection was used to resect the tumours with preservation of carotid arteries. Intra-luminal carotid shunts and vein grafts were prepared to be used if necessary. Results: There were 5 males and 2 females aging 17 - 46 with a mean of 32.9 ± 9.8 year. All patients had slowly growing painless pulsatile swelling below mandiblular angle for long durations (1 - 25 years) and a positive Fontaine’s sign. All tumours were benign, unilateral (right n = 4, left n = 3) and ranging in size from 3 × 3 cm to 6.4 × 3.2 cm. Beside US neck exam, carotid angiography was done in 5 patients. According to Shamblin classification, 4 were class II, 2 class I and 1 class III. All tumours were successfully resected with preservation of ICA. However, the ECA was safely ligated twice due to severe involvement. Tongue deviation occurred once (14.3%) but no patient died and none had stroke or recurrence. Conclusions: Our results of surgery for CBT compare very well with the international standards.展开更多
Carotid body tumour （CBT） is a rare neoplasm arising from para^an^lion cells of the carotid body.1 Sureical resection of the CBT is considered the primary treatment option, and the only one which can allow a definit...Carotid body tumour （CBT） is a rare neoplasm arising from para^an^lion cells of the carotid body.1 Sureical resection of the CBT is considered the primary treatment option, and the only one which can allow a definitive cure.^1-3 The resection is particularly difficult because the tumour is adherent to the carotid adventitia, is highly vascularized, often involves the cranial nerves, and is in a limited field for exposure, consequently, the intervention is associated with high morbidity due to risk of nervous injuries, stroke, was well as hemorrhage shock.^1-3展开更多
文摘Background: Carotid body tumours (CBTs) are rare tumours that arise from chemoreceptor cells at the bifurcation of carotid artery. Excision of CBT poses several anesthetic challenges and may be complicated with marked intraoperative hemodynamic instability and turbulent postoperative recovery. Attention to details and a meticulous anesthetic plan are essential for successful anesthetic management. Aim: To present anaesthetic management and challenges for carotid body tumour excision in a young Nigerian. Case Presentation: A 26-year-old man presented with left sided slow growing neck tumour. The tumour was completely excised with no anaesthetic or surgical complication. Histology and immunohistochemistry of the excised tumour confirmed paraganglioma. He was discharged fifteenth post-operative day. Conclusion: General anesthesia is the preferred technique. The basic elements of anesthetic management are protection of hemodynamic stability and maintenance of cerebral perfusion pressure (CPP).
文摘The carotid body is a small structure weighing 12 mg located in the adventitia of carotid artery bifurcation acting as a chemoreceptor. Carotid body tumour (CBT);formerly known as chemodectoma is a rare, highly vascular, mostly benign tumour arising from the paraganglia of carotid body;hence, the name (carotid paraganglioma). The high vascularity and proximity to cranial nerves and major vessels make this tumour a surgical challenge. Abundant literature has been written about CBT in the last century with a continuous debate regarding its etiology, natural history, biological behavior, proper technique of excision, and the morbidity and mortality associated with its resection. The purpose of this review article is to simplify understanding the basic and clinical aspects of this challenging neoplasm.
文摘Background: Carotid body tumour (CBT) is a rare neoplasm, yet it is the commonest head and neck paraganglioma. In Iraq, relevant literature is sparse. Herein, we present our second case series. Methodology: Patients with CBTs that were operated upon in the Department of Thoracic and Vascular Surgery, Baghdad Medical City from 2010 to 2014 were enrolled. History and examination were followed by a workup of duplex ultrasonography, CT scan, magnetic resonance imaging, CT or conventional carotid angiography. Surgical exploration via a standard anterolateral cervical incision and subadventitial dissection was used to resect the tumours with preservation of carotid arteries. Intra-luminal carotid shunts and vein grafts were prepared to be used if necessary. Results: There were 5 males and 2 females aging 17 - 46 with a mean of 32.9 ± 9.8 year. All patients had slowly growing painless pulsatile swelling below mandiblular angle for long durations (1 - 25 years) and a positive Fontaine’s sign. All tumours were benign, unilateral (right n = 4, left n = 3) and ranging in size from 3 × 3 cm to 6.4 × 3.2 cm. Beside US neck exam, carotid angiography was done in 5 patients. According to Shamblin classification, 4 were class II, 2 class I and 1 class III. All tumours were successfully resected with preservation of ICA. However, the ECA was safely ligated twice due to severe involvement. Tongue deviation occurred once (14.3%) but no patient died and none had stroke or recurrence. Conclusions: Our results of surgery for CBT compare very well with the international standards.
文摘Carotid body tumour （CBT） is a rare neoplasm arising from para^an^lion cells of the carotid body.1 Sureical resection of the CBT is considered the primary treatment option, and the only one which can allow a definitive cure.^1-3 The resection is particularly difficult because the tumour is adherent to the carotid adventitia, is highly vascularized, often involves the cranial nerves, and is in a limited field for exposure, consequently, the intervention is associated with high morbidity due to risk of nervous injuries, stroke, was well as hemorrhage shock.^1-3
