[Individualized treatment of bilateral carotid body tumor]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jan 7;52(1):37-43. doi: 10.3760/cma.j.issn.1673-0860.2017.01.007.
[Article in Chinese]

Abstract

Objective: To investigate individualized therapeutic strategy for bilateral carotid body tumors. Methods: Clinical data of 16 patients with bilateral carotid body tumor treated from January 2003 to August 2016 were retrospectively studied. Of the 16 patients, 9 were males and 7 were females; 5 were sporadic and 11 were familial; 8 cases were observed, 1 cases was malignant and treated with chemotherapy, and 7 cases were treated with surgery. The treatment course, perioperative complications and clinical efficacy were assessed. Comprehensive evaluation of bilateral carotid body tumors was performed based on the size of bilateral tumor, clinical manifestations, genetic tests and other indicators. Individual treatment strategies included observation, surgery and observation, bilateral surgery, radiotherapy or chemotherapy. Surgical resection of carotid body tumor was unilateral in 3 cases and bilateral in 3 cases; removal of bilateral carotid body tumors plus unilateral jugular bulb in 1 case; and the internal carotid artery was reconstructed with autologous greater saphenous vein in 1 case. Results: All patients were followed up for 3 months to 12 years. There was no patient death during perioperative period. Superior laryngeal nerve injury occurred in 2 case. Baroreceptor failure syndrome occurred in one patient, but it gradually recoverd with medical treatments. Conlusion: It is important to identify whether bilateral carotid body tumors are hereditary and to make an individualized therapeutic strategy for each patient with bilateral carotid body tumors, focusing on the improvement in the quality of life of patient.

目的: 确定个体化治疗策略在双侧颈动脉体瘤临床治疗中的作用。 方法: 回顾性分析北京同仁医院耳鼻咽喉头颈外科自2003年1月至2016年8月收治的16例双侧颈动脉体瘤患者的临床资料,16例患者中男性9例,女性7例;散发性5例,家族性发病11例。总结其治疗经过、围手术期并发症和临床疗效。根据双侧瘤体大小、临床表现和基因检测等指标进行综合评估,分别采取观察、手术加观察、双侧手术、放疗或者化疗等个体化治疗策略。本研究中心16例患者中,8例采取观察,1例诊断恶性行化疗,7例行手术治疗。7例手术患者中行单侧颈动脉体瘤切除者3例,双侧颈动脉体瘤均切除者3例,双侧颈动脉体瘤和鼓室球体瘤均切除者1例。其中1例术中行颈内动脉转流自体大隐静脉血管重建。 结果: 16例患者随访时间3个月至12年,无围手术期偏瘫和死亡,喉上神经损伤2例;1例术后出现压力感受器衰竭综合征,通过降血压和观察后症状消失。 结论: 双侧颈动脉体瘤患者要鉴别是否为遗传性,并根据瘤体大小等综合指标制订以提高生活质量为核心的个体化治疗方案非常重要。.

Keywords: Carotid body tumor; Individualized medicine; Postoperative complications; Surgical procedures, operative.

MeSH terms

  • Carotid Artery, Internal / surgery
  • Carotid Body Tumor / drug therapy*
  • Carotid Body Tumor / etiology
  • Carotid Body Tumor / pathology
  • Carotid Body Tumor / surgery*
  • Female
  • Humans
  • Laryngeal Nerve Injuries / etiology
  • Male
  • Postoperative Complications / etiology
  • Pressoreceptors / physiopathology
  • Quality of Life
  • Retrospective Studies