Netterville J L, Reilly K M, Robertson D, Reiber M E, Armstrong W B, Childs P
Department of Otolaryngology, Vanderbilt Medical Center, Nashville, Tenn 37232, USA.
Laryngoscope. 1995 Feb;105(2):115-26. doi: 10.1288/00005537-199502000-00002.
Minimal morbidity occurs with resection of most carotid body tumors (CBT). With larger tumors significant injury to the cranial nerves has been reported. In order to assess the operative sequelae rate, 30 patients with CBT were reviewed. Sixteen patients either presented with bilateral carotid body tumors or had previously undergone a resection of the contralateral carotid body tumors, for a total carotid body tumor count of 46. Sixteen patients demonstrated a familial pattern while 14 were nonfamilial. Within the familial group, 14 of 16 presented with multiple paragangliomas as compared to 6 of 14 in the nonfamilial group. Tumor size ranged from 0.8 to 12 cm. Vascular replacement occurred in 2 of 20 patients with tumors < 5.0 cm, compared with 5 of 9 with tumors > 5.0 cm. Four patients lost cranial nerves with the resection: superior laryngeal nerve (SLN), 4; cranial nerve X, 1; cranial nerve XII, 1. Ten patients developed baroreceptor failure secondary to bilateral loss of carotid sinus function. First-bite pain occurred in 10 of 25 operative patients. Cranial nerve loss can be minimal with resection of carotid body tumors, however, baroreceptor failure and first-bite pain are postoperative sequelae that are often disregarded in the postoperative period.
大多数颈动脉体瘤（CBT）切除术后的发病率较低。据报道，对于较大的肿瘤，可导致颅神经严重损伤。为了评估手术后遗症发生率，我们回顾了30例CBT患者。16例患者为双侧颈动脉体瘤，或之前已接受过对侧颈动脉体瘤切除术，颈动脉体瘤总数为46个。16例患者呈现家族性模式，14例为非家族性。在家族性组中，16例中有14例患有多个副神经节瘤，而非家族性组中14例中有6例。肿瘤大小范围为0.8至12厘米。20例肿瘤<5.0厘米的患者中有2例行血管置换，而9例肿瘤>5.0厘米的患者中有5例行血管置换。4例患者在切除术中出现颅神经损伤：喉上神经（SLN）损伤4例；第十对颅神经损伤1例；第十二对颅神经损伤1例。10例患者因双侧颈动脉窦功能丧失继发压力感受器衰竭。25例手术患者中有10例出现首次咬合疼痛。切除颈动脉体瘤时颅神经损伤可能较小，然而，压力感受器衰竭和首次咬合疼痛是术后后遗症，在术后往往被忽视。
