Ali Kemal GÜR, Esra EKER, Mehmet Coşkun AYKAÇ, Mahmut YARGI

Karotis cisim tümörü eksizyonu ile ilişkili komplikasyonlar

Amaç: Bu çalışmada karotis cisim tümörü eksizyonları ile ilişkili komplikasyonlar ve sonuçları değerlendirildi. Çalışma planı: Ocak 2013 - Nisan 2016 tarihleri arasında karotis cisim tümörü ön tanısı ile toplam 29 hasta (2 erkek, 27 kadın; ort. yaş 55.2±4.4 yıl; dağılım 17-76 yıl) ameliyat edildi. Shamblin karotis cisim tümörü sınıflamasına göre, 12 hasta tip 1, 13 hasta tip 2 ve dört hasta tip 3 idi. Bulgular: Başlıca semptomlar baş dönmesi, boyun bölgesinde ağrı, kulak çınlaması ve baş ağrısı idi. Bu semptomların en sık görüleni baş ağrısı idi. On hastada (%34.4) nörolojik ve cerrahi komplikasyonlar gelişti. Ameliyat edilen hastaların üçünde (%8.7) yutma güçlüğü, ikisinde (%6.8) fasiyal hemiparezi, ikisinde (%6.8) kanama, birinde (%3.4) hematom ile ilişkili solunum sıkıntısı, birinde (%3.4) sol hemiparezi ve birinde (%3.4) geçici bradikardi gelişti. Ekstübasyon sonrası kanama nedeniyle solunum sıkıntısı olan bir hasta tekrar ameliyata alındı. Fasiyal ve sol hemiparezili hastaların parezi durumları geçici idi. Yutma güçlüğü de, takip eden poliklinik kontrollerinde düzeldi. Hiçbir hastada kalıcı komplikasyon görülmedi. Sonuç: Cerrahi eksizyonun en uygun tedavi seçeneği olduğu karotis cisim tümörlerinde ameliyat sonrası komplikasyonlar, dikkatli diseksiyonlar ve ekartasyonlar ile en aza indirgenebilir. Özellikle sinir koruyucu cerrahiye dikkat edilmelidir

Complications associated with carotid body tumor excision

Background: This study aims to evaluate associated complications of carotid tumor excisions and outcomes. Methods: Between January 2013 and April 2016, a total of 29 patients (2 males, 27 females; mean age 55.2±4.4 years; range, 17 to 76 years) were operated with the preliminary diagnosis of a carotid body tumor. According to the Shamblin classification of carotid body tumors, 12 patients were type 1, 13 patients were type 2, and four patients were type 3.Results: Main symptoms were dizziness, pain in the neck area, tinnitus, and headache. Headache was the most common symptom among them. Neurological and surgical complications developed in 10 patients (34.4%). Of operated patients, dysphagia developed in three (8.7%), facial hemiparesis in two (6.8%), hemorrhage in two (6.8%), hematoma-related respiratory distress in one (3.4%), left hemiparesis in one (3.4%), and transient bradycardia in one (3.4%). The patient who had respiratory distress associated with bleeding following extubation was reoperated. In the patients with facial and left hemiparesis, paresis was transient. Dysphagia also resolved in the subsequent follow-up outpatient visits. None of the patients experienced a permanent complication.Conclusion: Surgical excision is the most appropriate choice of treatment in carotid body tumors, and postoperative complications can be minimized through careful dissections and retractions. A special attention should be paid to nerve-preserving surgery.

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