Impact of Radiological Predictors on Surgical Management and Outcome of Carotid Body Tumor Resection / by Abdelrahman Salah ElSobhy Mohamed ; Supervised by Prof. Dr. Ayman Abdelwahab, Dr. Romany Esshak, Dr. Kareem Sallam.

Thesis (M.Sc.)-Cairo University, 2023.

Bibliography: pages 105-120.

CBTs represent more than half of neck paragangliomas, yet still a very rare cause of neck lumps.
Like other paragangliomas, CBTs originate from the neural crest. These lesions are rare before
the age of 20. Recent studies have reported that CBTs are more common in females rather than
males (1.9:1) but, there are some Asian centers reporting their data vice versa.
The mechanisms of carotid body tumor formation remain unknown, but since 1930 it has been
accepted that the carotid body is a chemoreceptor which monitors the oxygen tension of
systemic arterial blood. Thus carotid body tumors are associated with conditions producing
chronic hypoxia, such as high altitude.
CBT is one of the most commonly seen jugular paraganglioma involving the carotid body
chemoreceptors, but rarely seen clinically, so the corresponding diagnosis and management
remain difficult. They present a surgical challenge because of the frequent complications and
difficulties caused by their high vascularity, proximity and possible infiltration of the carotid
bifurcation, compression of cranial nerves in the neck, and extension to the skull base. CBTs are
so rare that management recommendations based on the usual prospective trials or by meta-
analysis are not practical. Because of the infrequent performance of CBT surgical procedures,
individual surgeons or single institutions cannot accumulate a sufficient number of cases to
report or evaluate their outcomes with statistical confidence. An attempt to predict the
difficulties encountered during resection and the outcome of treatment at our institution was
made by reviewing our experience of this rare disease.
Objectives:
To plan a radiological based surgical approach during CBT resection , analyze indications of
vascular reconstruction, technique and types of vascular graft, outcomes following surgical
intervention and the role of pre-operative embolization
Patients and methods:
A retrospective study which was conducted on all patients diagnosed with carotid body tumor
(20 patients) attending the National Cancer Institute between January 2007 and November
2022 and underwent CBT resection inside the surgical department

يمثل العلاج السلوكي المعرفي أكثر من نصف الأورام العقدية العصبية في الرقبة، ومع ذلك لا يزال سببًا نادرًا جدًا لكتل ​​الرقبة.
مثل أورام المستقتمات العقدية العصبية الأخرى، ينشأ العلاج السلوكي المعرفي من العرف العصبي. هذه الآفات كانت نادرة من قبل
سن 20. أفادت الدراسات الحديثة أن العلاج السلوكي المعرفي أكثر شيوعًا عند الإناث منه
الذكور (1.9:1) ولكن هناك بعض المراكز الآسيوية تنشر بياناتها بالعكس.
لا تزال آليات تشكل ورم الجسم السباتي غير معروفة، لكنها كانت كذلك منذ عام 1930
من المقبول أن الجسم السباتي هو مستقبل كيميائي يراقب توتر الأكسجين
الدم الشرياني الجهازي. وهكذا ترتبط أورام الجسم السباتي بالظروف المنتجة
نقص الأكسجة المزمن، مثل الارتفاعات العالية.

Issued also as CD

Text in English and abstract in Arabic & English.