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Surgical Management of Carotid Body Tumor and Risk Factors of Postoperative Cranial Nerve Injury

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Abstract

Background

To identify risk factors of postoperative cranial nerve injury (CNI) following surgical treatment of a carotid body tumor (CBT) by retrospective analysis of the data during the past decade in our center.

Methods

From May 2008 to September 2018, patients who underwent CBT resections at the Department of Vascular Surgery, Zhongshan Hospital, Fudan University, were included in the study. Demographic, preoperative, intraoperative, and postoperative data of patients were collected and analyzed. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors of CNI.

Results

A total of 203 CBTs were excised in 196 patients; 17.7% was classified as Shamblin I, 59.1% as Shamblin II, and 23.2% as Shamblin III. CNI after surgery occurred in 57 (28.1%) patients. Postoperative CNI, external carotid artery (ECA) ligation, internal carotid artery (ICA) reconstruction, tumor volume, and established blood loss (EBL) were significantly correlated with Shamblin classification. On univariate analysis, there were statistically significant differences in Shamblin classification (p = 0.002), tumor volume (p = 0.014), number of lymph nodes removed (NOLNR) (p < 0.001), and EBL (p = 0.019) between two groups (with and without CNI after surgery). Multivariate logistic regression analysis revealed a significant positive correlation between CNI and Shamblin III (AOR, 4.744; 95% CI, 1.21–18.56; p = 0.025) and NOLNR (AOR, 0.25; 95% CI, 1.23–1.46 for each three-interval increase, p < 0.001).

Conclusions

Shamblin III and NOLNR are independent risk factors of CNI for patients who undergo CBT resections.

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Acknowledgements

Grant support: This work was supported by the training program for outstanding academic leaders of the Shanghai health and family planning system [Hundred Talent Program, grant number 2018BR40]; China National Natural Science Funds [Grant No. 30801122]; and Shanghai Rising-Star Program [grant number 19XD1401200].

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Author notes

  1. Xiaolang Jiang and Gang Fang authors contributed equally to this work.

Authors and Affiliations

  1. Institute of Vascular Surgery, Department of Vascular Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Xiaolang Jiang, Gang Fang, Daqiao Guo, Xin Xu, Bin Chen, Junhao Jiang, Zhihui Dong & Weiguo Fu

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  1. Xiaolang Jiang
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  2. Gang Fang
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  3. Daqiao Guo
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  4. Xin Xu
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  5. Bin Chen
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  6. Junhao Jiang
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  7. Zhihui Dong
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  8. Weiguo Fu
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Corresponding authors

Correspondence to Zhihui Dong or Weiguo Fu.

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We have no conflicts of interest to declare.

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Obtained from all individual participants included in the study.

This study design was approved by the Ethics Committee of Zhongshan Hospital, Fudan University, Shanghai, China.

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Jiang, X., Fang, G., Guo, D. et al. Surgical Management of Carotid Body Tumor and Risk Factors of Postoperative Cranial Nerve Injury. World J Surg 44, 4254–4260 (2020). https://doi.org/10.1007/s00268-020-05723-8

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  • DOI: https://doi.org/10.1007/s00268-020-05723-8

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