Intraoperative Accident and Associated Factors in Carotid Body Tumor Surgery at Tertiary Hospital in Addis Ababa ,Ethiopia
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Date
2023-09
Authors
Beshir Abdi
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Publisher
Addis Ababa University
Abstract
Background – Carotid body tumors (CBTs) are the rare tumors of the head and neck region,accounting for 60% of the cervical paragangliomas. CBTs classified etiologically into sporadic,hyperplastic and familial type. Anatomic classification designed by shamblin describes howCBTs envelope carotid vessel and grouped into 3 according to degree of encasement. Patientscommonly present with slowly growing painless mass at carotid triangle. They may have localcompressive symptoms like dysphagia or dysphonia.Surgical excision is safe and maintreatment option for resectable CBTs. However, complication like bleeding, cranial nerve injury,and stroke continue to be major concerns even in the hands of experienced surgeon. Therefore,the study aimed to assess intraoperative accident during carotid body tumor excision at tertiaryhospital in Ethiopia.
Method: A retrospective cross-sectional study was conducted among 153 patient operated over the past 10 years period by reviewing medical record at tertiary hospital in Ethiopia. Datawas collected through structured questionnaire. The data was summarized using frequency(percentage) table and graph. To identify significant factor associated with intraoperativeaccident, mulitvariable binary logistic regression model was used, where Adjusted Odds Ratio(AOR), 95% CIs for AOR and p-value were used for interpretation.
Result: Among 153 cases patient operated 132(86.3%) were female and mean age was 39.42±11.161. . Almost all patient presented with neck mass (98.7%) which were painless in 58.8% ofcases. Most patient presented more than 3 years after onset of symptoms (61.5%).Tumor sizemore 5 cm was found in 72.1% of cases. Patients were mostly investigated with neckultrasound(97.4%) and neck CT(71.22%). Overall, 14.45% were Shamblin I CBTs; 54.2% wereShamblin II; and 31.4% were ShamblinIII. There were Intra operative accident in 24.8 % ofpatient. Hypoglossal nerve (9.2%) and ECA (9.2%) were commonly injured structure. shamblinclass of the tumor was found to be significant exposure for the development of intraoperativeaccident for those shamblin III as compared to shamablin I with odds increasing with shamblinclass (AOR=6.6067, 95% CI=1.07,34.4, p=0.018 for shamblin III).
Conclusion : The prevalence of intraoperative accident during CBT excision in our setupcomparable with the current literature from different country which implies CBT excision canbe done safely in our institution with acceptable level complication with available resource.major factor associated withintraoperative accident was shamblin class of the tumour.
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Keywords
Intraoperative accident Carotid Body Tumor surgery