Twenty six cases with carotid body tumours (27 tumors) were operaterated on from November,1988 to October, 1997. Eleven of the 26 cases were misdiagnosed in other hospital. Twenty six cases experienced B-mode ultrasonic scanning and 18 carotid arteriography. Seventeen cases underwent general hypothermic anesthesia (30℃-32℃) and 9 general carotid-internal carotid shunt. Eight cases (9 tumors) experienced simple excision of tumor, 3 resection of the tumor with external carotid, 11 excision of the tumor with internal, external and general carotid and carotid-reconstructing. Two cases underwent anestomosis of general carotid with internal carotid and 2 ligation of the internal carotid. All patients showed good results but one complicated with hemiplegia. The authors consider that misdiagnosis can be avoided with careful physical examination, Bmode ultrasonic scanning and arteriography, and hypothermic general anesthesia and intraoperative general carotid internal carotid shunt were important measures for the protection of brain.
Objective To investigate the experience of selective embolization combined with intraoperative internal carotid artery shunt for surgical treatment of carotid body tumor (CBT). Methods The data of 21 patients (22 sides) with CBT who underwent surgical resection from January 2002 to July 2012 in our hospital were retrospectively reviewed. The all patients’ conditions were fully assessmented and all patients were performed the carotid arteriography and superselective embolization treatment for the blood supply of tumor by with microcatheter on 2-3 days before operation,and then intraoperative internal carotid artery shunt and resection of carotid body tumors were performed. Results Surgical procedures were successfully performeded in all 21 patients (22 sides). Among them, 16 patients (17 sides) were taken carotid body tumor resected, 5 patients were taken carotid body tumor resected and internal carotid artery reconstruction (autogenous long saphenous vein were used in 3 patients, vascular prosthesis were used in 2 patients). The postoperative complications were found in 5 patients after anesthesia recovery, which included crooked tongue in 3 cases and facial numbness in 2 cases, and they were cured in 3 months. There were no cerebral infarction, hemiplegia, and death cases. All 21 patients were followed-up for a period from 2 months to 9 years(average 57 months), there was no tumor recurred. Conclusions Surgical resection is the first choice for treatment of carotid body tumor. The application of selective embolization and intraoperative internal carotid artery shunt for surgical treatment of carotid body tumor in complicated Shamblin Ⅲ stage is safe and effective.
目的 总结颈动脉体瘤的诊断和外科手术治疗的经验。 方法 分析我院1991年9月至2009年2月期间手术治疗的16例颈动脉体瘤患者的临床资料。 结果 术前均行彩色多普勒超声检查,9例行CT检查,6例行数字减影血管造影检查。3例首诊时误诊为其他疾病。11例行单纯瘤体切除; 5例采用大隐静脉行颈动脉重建。术后1例出现声音嘶哑,1例出现伸舌右偏,1例出现呼吸困难。10例获得7个月~15年(平均67个月)随访,未见复发和转移。 结论 临床医师应提高对颈动脉体瘤的认识,注意选择合适的检查方法以免误诊,外科手术切除是首选的治疗措施,大隐静脉重建颈动脉是一种较安全、有效的治疗方法。
目的 探讨对侧颈动脉已被切除的颈动脉体瘤的手术方法。方法 左颈动脉体瘤患者1例,女,54岁。右侧颈动脉31年前因右颈动脉体瘤手术已经切除,本次手术以成对的蚊式钳逐步直接分离至瘤体与颈内动脉的Gordon-Tayler白线,在保证颈内动脉完整的情况下,完整切除瘤体及包裹其内的颈外动脉。结果 患者术后无声音嘶哑、呛咳、头晕等并发症,顺利出院。结论 充分的术前准备及正确的分离平面是保证手术顺利的关键。
Objective To sum up the diagnosis, treatment, and prevention of postoperative complications of carotid body tumor. Methods The clinical data of 27 patients (30 aneurysms) with carotid body tumor who treated in our hospital from June 2005 to June 2016 were analyzed retrospectively. Results Of the 27 patients, 24 patients had unilateral lesions and 3 patients had bilateral lesions, with a total of 30 aneurysms. Three patients received color Doppler ultrasound, 18 patients received computed tomography angiography, 3 patients received magnetic resonance angiography, and 6 patients received digital subtraction angiography. According to Shamblin classification: 10 aneurysms belonged to typeⅠ, 16 aneurysms belonged to typeⅡ, 4 aneurysms belonged to type Ⅲ. Twenty aneurysms were treated with simple stripping, 6 aneurysms were treated with tumor resection and external carotid artery resection, 2 aneurysms were resected by resection, partial carotid artery resection plus external-internal carotid artery anastomosis, 2 aneurysms were resected by resection, resection of internal carotid artery, external carotid artery, and common carotid artery, as well as internal carotid artery-common carotid artery bypass. All patients underwent a successful operation with no death. After surgery,1 patient suffered from hemiplegia, 2 patients suffered from hoarseness, and 1 patient suffered from cough. Of the 27 patients, 24 patients were followed-up from 3 months to 4 years, with a median time of 2.3 years. During the follow-up procedure, the 1 patient with hemiplegic recovered to more than three levels of muscle strength after 6 months after rehabilitation, the 2 patients with hoarseness and 1 patient with cough returned to normal after 2 months after symptomatic treatment. There was no recurrence during follow-up procedure, and no other complications occurred. Conclusion Computed tomography angiography and magnetic resonance angiography are propitious to the definitive diagnosis of carotid body tumor, and actively surgical treatment should be performed once diagnosis of carotid body tumor.