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周 政, 吴 牡, 李 维, 艾 金, 张 晓, 陈 玉, 宋 业, 王 芳, 沈 阳, 谭 国. [Baroreceptor failure syndrome after head and neck tumor surgery]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:1052-1056. [PMID: 34886615 PMCID: PMC10128367 DOI: 10.13201/j.issn.2096-7993.2021.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Indexed: 04/30/2023]
Abstract
With the continuous updating of head and neck surgery concepts and techniques, more and more head and neck surgeries are developing in the direction of refinement.however, the more complete the surgery, the greater the possibility of subsequent nerve exposure and injury. Even a slight perturbation of the nerve may cause serious complications, such as pressure receptor failure.It is necessary to review the mechanisms and the characteristics of baroreceptor failure syndrome after head and neck tumor surgery.
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Affiliation(s)
- 政 周
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 牡丽 吴
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 维 李
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 金刚 艾
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 晓伟 张
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 玉 陈
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 业勋 宋
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 芳 王
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 阳 沈
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
| | - 国林 谭
- 中南大学湘雅三医院耳鼻咽喉头颈外科(长沙,410005)
- 谭国林,
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Bryant JP, Wang S, Niazi T. Carotid Body Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1296:151-162. [PMID: 34185291 DOI: 10.1007/978-3-030-59038-3_9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Carotid body tumors (CBTs) are rare paragangliomas, comprising 0.5% of all head and neck tumors, and 65% of head and neck paragangliomas. A majority of CBTs occur sporadically, while 15% are familial or hyperplastic in the setting of chronic hypoxia. They usually present as unilateral, well-circumscribed rubbery masses, arising at the level of the carotid bifurcation. A majority of CBTs are painless and therefore may evade diagnosis for months to years. Symptomatic lesions occur due to progressive cranial nerve IX, X, or XII dysfunction, manifesting as hoarseness, dysphagia, vertigo, coughing, or odynophagia. Other local symptoms include neck discomfort, pulsatile tinnitus, hearing loss, or carotid sinus syndrome. Appropriate workup includes a thorough physical exam followed by radiographic imaging, vascular studies, and biochemical workup with 24 h urinary catecholamine or metanephrine analysis. The management of these tumors, which involves standalone surgical resection or following embolization for larger and more vascular tumors, will also be discussed.
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Affiliation(s)
| | - Shelly Wang
- Miller School of Medicine, University of Miami, Miami, FL, USA.,Division of Pediatric Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, FL, USA
| | - Toba Niazi
- Miller School of Medicine, University of Miami, Miami, FL, USA. .,Division of Pediatric Neurosurgery, Brain Institute, Nicklaus Children's Hospital, Miami, FL, USA.
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Bobadilla-Rosado LO, Garcia-Alva R, Anaya-Ayala JE, Peralta-Vazquez C, Hernandez-Sotelo K, Luna L, Cuen-Ojeda C, Hinojosa CA. Surgical Management of Bilateral Carotid Body Tumors. Ann Vasc Surg 2019; 57:187-193. [PMID: 30684613 DOI: 10.1016/j.avsg.2018.10.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/27/2018] [Accepted: 10/04/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Carotid body tumors (CBTs) are rare neoplasms located in the carotid bifurcation. The majority of these tumors are unilateral; bilateral CBTs represent approximately 5% of all affected patients, and the recommended treatment is to surgically remove them in staged-planned surgeries. We describe the experience, outcomes, and the surgical management of bilateral CBTs in our institution. METHODS A retrospective review of CBTs patients was completed; patient demographics, comorbidities, lesion location, anatomic characteristics, surgical techniques, complications, reinterventions, and other factors that may influence outcomes were evaluated. RESULTS A total of 109 patients with CBTs were treated surgically; of these, 8 had bilateral CBTs (7%); the mean age was 56 years, and 7 (87%) were females. Thirteen surgical resections were performed, and in 2 of the cases, the pathology report was malignant (15%). Five were classified as Shamblin I (31%), 5 as Shamblin II (31%), and remaining 6 as Shamblin III (38%). The mean time between the first and second procedure was of 10.7 months. Complications included one case of neck hematoma requiring evacuation and postoperative neurologic complications occurred in three patients (one patient with facial and two with vocal cord palsies). None of the studied individuals had a family history of CBT, and all of them lived in altitude areas higher than 2000 meters above mean sea level (mamsl). The mean tumor size was 3.55 cm and 2.75 cm for right and left CBTs, respectively. CONCLUSIONS A better understanding of the clinical characteristics of patients with bilateral CBTs may lead to a more standardized and optimal management with fewer complications and a better quality of life afterward.
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Affiliation(s)
- Luis O Bobadilla-Rosado
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Ramon Garcia-Alva
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Javier E Anaya-Ayala
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Cynthia Peralta-Vazquez
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Kemberly Hernandez-Sotelo
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Lizeth Luna
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Cesar Cuen-Ojeda
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico
| | - Carlos A Hinojosa
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubirán, Mexico City, Mexico.
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Burgess A, Calderon M, Jafif-Cojab M, Jorge D, Balanza R. Bilateral carotid body tumor resection in a female patient. Int J Surg Case Rep 2017; 41:387-391. [PMID: 29545998 PMCID: PMC5697994 DOI: 10.1016/j.ijscr.2017.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Carotid body tumors also called carotid paragangliomas are rare neuroendocrine neoplasms derived from neural crest cells, approximately 3% of all paragangliomas occur in the head and neck area (Xiao and She, 2015); although they represent 65% of the head and neck paragangliomas (Georgiadis et al., 2008). PRESENTATION OF CASE We present the therapeutic management of a 65-year-old woman with bilateral carotid body tumors. The patient presented to medical clinic for unrelated signs and symptoms of weight loss, dyspepsia, and epigastric pain. Physical examination showed bilateral non-tender neck masses for which imaging studies were ordered resulting in the diagnosis of bilateral carotid tumor. Surgical resection was staged with one week of distance between each tumor resection. DISCUSSION Carotid Body Tumors can arise from the paraganglia located within the adventitia of the medial aspect of the carotid bifurcation.Resection is the only curative treatment. Carotid body tumors resection represents a special challenge due to potential neurovascular complications. CONCLUSIONS Surgical resection of carotid body tumors represents a special challenge to the surgeon because of the complex anatomical location of the tumor, including close relationship with the cranial nerves, involvement of the carotid vessels and large vascularization of the tumor. With the advance of diagnosis and improvement in surgical techniques as well as the understanding of biological behavior of tumors, surgical treatment has become a safer alternative for treating these tumors.
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Ghali MG, Srinivasan VM, Hanna E, DeMonte F. Overt and Subclinical Baroreflex Dysfunction After Bilateral Carotid Body Tumor Resection: Pathophysiology, Diagnosis, and Implications for Management. World Neurosurg 2017; 101:559-567. [DOI: 10.1016/j.wneu.2017.02.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 11/25/2022]
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Tyagi R, Munjal M, Kaur P, Kaur H, Sood N. Parotid or carotid? Misled by site. Diagn Cytopathol 2017; 45:569-573. [PMID: 28262005 DOI: 10.1002/dc.23698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/05/2017] [Accepted: 02/08/2017] [Indexed: 11/06/2022]
Abstract
We present an interesting scenario where a 64 years old male presented with a long standing painless, infra-auricular swelling, which had progressively increased in size. Based on the site, the clinical impression was of a salivary gland lesion and FNAC was performed. The smears were unusually cellular and had necrotic background. The cytological diagnosis was a cystic neoplasm of salivary gland, possibly mucoepidermoid carcinoma. Warthin's tumor was also kept in differential. However, the radiological investigations, which were made available after the FNAC report were conflicting with cytological diagnosis of a malignancy and were characteristic of a carotid body tumor, generally a benign neoplasm. Surgical excision of the tumor with regional lymph node sampling was done and histopathological examination solved the puzzle by revealing metastasis of paraganglioma to right posterior triangle lymph nodes. This case is unique because of the unusual presentation of a malignant paraganglioma as an infra-auricular swelling, which was clinically considered as a parotid tumor. The clinician as well as the pathologist need to be aware of such diagnostic pitfall. Diagn. Cytopathol. 2017;45:569-573. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Ruchita Tyagi
- Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India
| | - Manish Munjal
- Department of ENT, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Pavneet Kaur
- Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India
| | - Neena Sood
- Department of Pathology, Dayanand Medical College AND Hospital, Ludhiana, Punjab, India
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Galyfos G, Stamatatos I, Kerasidis S, Stefanidis I, Giannakakis S, Kastrisios G, Geropapas G, Papacharalampous G, Maltezos C. Multidisciplinary Management of Carotid Body Tumors in a Tertiary Urban Institution. Int J Vasc Med 2015; 2015:969372. [PMID: 26783464 PMCID: PMC4689957 DOI: 10.1155/2015/969372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 11/30/2015] [Accepted: 12/01/2015] [Indexed: 11/17/2022] Open
Abstract
Objective. Aim of this study is to present the experience of our institution in carotid body tumors (CBTs) treatment. Methods. All cases treated in a Vascular Surgery Department within 2.5 years (03/2013-09/2015) were retrospectively evaluated. Demographics, diagnostic, and treatment strategy were recorded. All patients with known CBT underwent ultrasound and magnetic resonance imaging preoperatively. All cases were classified according to the Shamblin type and evaluated by a radiologist, otolaryngologist, and anesthesiologist before and after surgery. Major outcomes included mortality, stroke, cranial nerve injury, and recurrence. Results. Overall, nine patients (mean age: 59.5 ± 16.3 years) with a total of ten CBTs were treated. There was no gender prevalence and most of the cases (55%) were asymptomatic. There were no functional or familial cases. There was only one bilateral case treated in a staged manner. No preoperative embolization of CBTs was performed. Mortality and stroke rates were null. No severe complication was observed in the early and late setting. No malignancy was recorded. Mean follow-up was 15.6 ± 7.8 months. Conclusions. Multidisciplinary management of patients with CBTs is imperative for optimal results, especially in type III tumors, bilateral or functional cases. After careful treatment planning and intraoperative manipulations, complications could be avoided even without preoperative embolization.
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Affiliation(s)
- George Galyfos
- Department of Vascular Surgery, KAT General Hospital, 14561 Athens, Greece
| | - Ioannis Stamatatos
- Department of Vascular Surgery, KAT General Hospital, 14561 Athens, Greece
| | - Stavros Kerasidis
- Department of Vascular Surgery, KAT General Hospital, 14561 Athens, Greece
| | - Ioannis Stefanidis
- Department of Vascular Surgery, KAT General Hospital, 14561 Athens, Greece
| | | | | | - Georgios Geropapas
- Department of Vascular Surgery, KAT General Hospital, 14561 Athens, Greece
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Altinbas NK, Unal S, Peker A, Uzun C, Akkaya Z, Peker E. Trifurcation of the Left Common Carotid Artery. Pol J Radiol 2015; 80:376-8. [PMID: 26300999 PMCID: PMC4527113 DOI: 10.12659/pjr.894579] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/31/2015] [Indexed: 11/09/2022] Open
Abstract
Background Trifurcation of the common carotid artery is an unusual variation. Case Report We report a case of left common carotid artery trifurcation in a 74-year-old man. The left common carotid artery divided into the internal carotid, external carotid and facial arteries. Herein, the anatomy of the carotid arteries and the Doppler sonography and CT angiography findings of the left common carotid artery trifurcation were described with images. Conclusions The variations of the carotid arteries should be known to avoid and reduce the complications during the invasive procedures.
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Affiliation(s)
- Namik Kemal Altinbas
- Department of Radiology, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - Sena Unal
- Department of Radiology, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - Ahmet Peker
- Department of Radiology, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - Caglar Uzun
- Department of Radiology, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - Zehra Akkaya
- Department of Radiology, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - Elif Peker
- Department of Radiology, Ankara University Faculty of Medicine, Ibni Sina Hospital, Ankara, Turkey
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