Abstract
Objective
Depending on the size and location of the tumor, carotid body tumor (CBT) resection
can come with various complications, mostly intraoperative bleeding, and cranial nerve
injuries. In the present study, we aim to evaluate two fairly new variables, tumor
volume, and distance to the base of the skull (DTBOS), with operative complications
of carotid body tumor (CBT) resection.
Method
Patients who underwent carotid body tumor surgery in Namazi hospital from 2015 to
2019 were studied using standard databases. Tumor characteristics and distance to
the base of the skull were measured via computed tomography or Magnetic resonance
imaging. Outcomes, including intraoperative bleeding and cranial nerve injuries, along
with perioperative data were collected.
Results
A total of 42 cases of CBT were evaluated with an average age of 53.21±12.8 and mostly
female (85.7%). Based on Shamblin scoring, 2 (4.8%) were classified as group I, 25
(59.5%) as group II, and 15 (35.7%) as group III. The amount of bleeding significantly
increased with an increase in the Shamblin scores (P=0.031; median: I: 45cc; II: 250cc,
III: 400cc). Also, there was a significant positive correlation between the size of
the tumor and the estimated amount of bleeding (Correlation Coefficient = 0.660; P<0.001),
and also a significant reverse correlation with between bleeding and DTBOS (Correlation
Coefficient= -0.345; P=0.025). During the follow-up of the patients, six (14.3%) had
abnormalities in their neurological evaluation. Receiver operating characteristic
curve analysis revealed the size of tumor cutoff level 32.7 cm3 (3.2cm radius) to be most predictive of post-op neurological complication with an
area under the curve=0.83, sensitivity=83.3%, specificity=80.6%, a negative predictive
value= 96.7%, and positive predictive value of 41.7%, and an accuracy of 81.0%. Furthermore,
based on the predictive power of the models in our study, we demonstrated that a combination
model including the tumor size, DTBOS, along with the Shamblin score had the most
predictive power for neurological complications.
Conclusion
By evaluating CBT size and distance to the base of the skull, paired with the use
of the Shamblin classification, a better, more insightful understanding of possible
risks and complications of CBT resection can be obtained, leading to deserved levels
of patient care.
Keywords
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Article info
Publication history
Accepted:
February 24,
2023
Received in revised form:
February 22,
2023
Received:
October 13,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
