Flores EMH, Serrano LJA, Rosas FMA, Huerta HH, Meza VMA, Cisneros TMA, Jordán LJC, Sánchez NNE, Ramírez MC

Language: Spanish
References: 38
Page: 53-62
PDF size: 444.16 Kb.

ABSTRACT

Introduction: Carotid body tumors are very unfrequent neoplasyas, originated from the quimiotactic organs, located in the adventicia layer in the carotid bifurcation. They are also known as carotid glomus, quemodectomas or paraganglyomas. The paraganglyomas are usually bening tumors, highly vascularized, their cells are originated from the embrionary neural crest, they are located along the arteries and cranial nerves of the brachyal arches, being seldom in the Cervico-facial region. It is very well stablished the early surgical treatment of these tumors, by the complete excision thoroughly subadventitial resection, that reaches low indexes of morbimortality.
Objective: To analyze the experience in the management of patients with carotid glomus diagnosis in the department of angiology and vascular surgery.
Methodology: By means of a descriptive observational and retrospective design, we reviewed the clinical files of the patients that were admitted with carotid body tumor diagnosis in the department of angiology and vascular surgery of the Regional Hospital "Lic. Adolfo López Mateos" from the institute of social security and services for state workers (ISSSTE). During the period between may 2003- may 2006.
Outcome: 16 files were collected, but one were excluded, because it didn't have complete information, therefore 15 files were left to analyze, from which 14 were women, the mean age 56.53 years, interval between 29 and 78 years, in 100% of patients the clinical sign most recognized was is hypertrophy neck mass. The gold standard diagnostic study was the arteriography for all patients, supported in doppler dupplex ultrasound and CT. The management employed in the whole group of patients was subadventitial resection by anterior cervical approach. According to Shamblin's classification 73.73% (11) of patients were grade II y 26.66% (4) grade III, the mean surgical time was 1 hour and 48 minutes. The transoperatory bleeding reported was between 200 and 1600 cc. (mean bleeding volume 486.66 cc).
Conclusions: Diagnosis of a carotid body tumor is very unusual, it is more frequent in women and it is detected by observation of a located hypertrophic neck mass. Arteriography is the most accurate diagnostic study, and its treatment always surgical, but delicate regarding the anatomic region operated. Thus is recommended to be performed by experienced and trained surgeons in surgery of the neck and trained in the management of vascular injuries which it is a warranty for the patient for a better prognosis, healing and less morbimortality.

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