Risk factors of neurologic complications after surgical resection of carotid body tumor

Jinsong Wang, Yonghui Li, C. Yao, G. Chang, Zuojun Hu, Zi-lun Li, Mian Wang, Shenming Wang
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Abstract

Objective To investigate risk factors of nerve injury after carotid body tumor resection. Methods From 1991 to 2016, the clinical data of patients with neurologic complications after resection of carotid body tumor was retrospectively analyzed. Logistic regression analysis was used to investigate the risk factors of nerve injury. Results A total of 132 patients with 142 tumors underwent surgery. 45 patients (46 sides) suffered nerve injury, including 4 strokes and 44 nerve injuries. After active rehabilitation, 18 cases were left with permanent nerve injury, and the 4 patients with strokes regained self-care ability. By multivariate regression analysis, high-lying tumors (OR=4.345, P=0.005), Shamblin Ⅲ tumor (OR=4.382, P=0.047) increase the risks of postoperative nerve injury. Resection of high-lying tumors carried a higher risk of developing permanent nerve injury (OR=7.290, P=0.001). Conclusions Neurologic complication could be alleviated by rehabilitation. Intraoperative abrupt rupture of carotid artery is the leading cause of stroke. Shamblin Ⅲ and high-lying tumor are the predictors of postoperative nerve injury. Key words: Carotid body tumor; Postoperative complications; Nerve injury; Risk factors
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颈动脉体瘤切除术后神经系统并发症的危险因素分析
目的探讨颈动脉体瘤切除术后神经损伤的危险因素。方法回顾性分析1991 ~ 2016年颈动脉体瘤切除术后出现神经系统并发症患者的临床资料。采用Logistic回归分析探讨神经损伤的危险因素。结果132例142个肿瘤接受手术治疗。神经损伤45例(46侧),其中中风4例,神经损伤44例。经积极康复治疗后,18例患者留下永久性神经损伤,4例脑卒中患者恢复自理能力。多因素回归分析显示,高位肿瘤(OR=4.345, P=0.005)、ShamblinⅢ肿瘤(OR=4.382, P=0.047)增加了术后神经损伤的风险。切除高位肿瘤发生永久性神经损伤的风险较高(OR=7.290, P=0.001)。结论康复治疗可减轻神经系统并发症。术中颈动脉突然破裂是脑卒中的主要原因。ShamblinⅢ和高位肿瘤是术后神经损伤的预测因子。关键词:颈动脉体瘤;术后并发症;神经损伤;风险因素
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