Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience
Abstract Objective To evaluate the effects and outcomes of multidisciplinary surgical approaches in the management of carotid body tumors (CBT). Methods A single‐center retrospective study at the University of California—Los Angeles Medical Center was conducted on patients who presented with CBTs an...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.1130 |
| _version_ | 1797648926054023168 |
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| author | Kirsten Wong Kenric Tam Eric K. Tran Dipti Sajed Maie St. John |
| author_facet | Kirsten Wong Kenric Tam Eric K. Tran Dipti Sajed Maie St. John |
| author_sort | Kirsten Wong |
| collection | DOAJ |
| description | Abstract Objective To evaluate the effects and outcomes of multidisciplinary surgical approaches in the management of carotid body tumors (CBT). Methods A single‐center retrospective study at the University of California—Los Angeles Medical Center was conducted on patients who presented with CBTs and underwent surgical resections from 1998 to 2020. Statistical analysis was performed using IBM SPSS v27 and Excel. Results A total of 75 patients with 79 CBT resections were included. Operating surgical subspecialties included: 41.8% vascular surgery, 24.1% otolaryngology head and neck surgeons (OHNS), and 31.6% combined OHNS and vascular. 68.4% of tumors underwent preoperative embolization. EBL was directly correlated with tumor size. CBT size was similar for OHNS (30 mm) and vascular (31 mm) but was significantly larger for combined OHNS and vascular cases (38 mm). EBL was higher in combined cases (301 mL) compared to OHNS (124 mL) or vascular (203 mL) alone. Incidence of postoperative cranial nerve deficits was 7.8%, with combined OHNS and vascular cases having an incidence of 4.0% when compared to OHNS (5.3%) versus vascular surgery alone (12.1%). Conclusion CBTs can be managed effectively by single surgical specialties with similar outcomes between vascular surgery and OHNS. In larger, higher grade tumors, however, a combined vascular and OHNS approach had lower incidence of postoperative cranial nerve injuries when compared to single specialty resections, despite a larger EBL. Thus, a multidisciplinary surgical approach suggests favorable outcomes with fewer incidence of cranial nerve deficits for larger, more complex CBT resections. Level of Evidence 2b—Individual retrospective cohort study. |
| first_indexed | 2024-03-11T15:39:04Z |
| format | Article |
| id | doaj.art-44a7bc8ed28f4bc490c41bb7164dbf41 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-11T15:39:04Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-44a7bc8ed28f4bc490c41bb7164dbf412023-10-26T12:36:34ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-10-01851203120910.1002/lio2.1130Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experienceKirsten Wong0Kenric Tam1Eric K. Tran2Dipti Sajed3Maie St. John4David Geffen School of Medicine University of California Los Angeles California USADavid Geffen School of Medicine University of California Los Angeles California USADavid Geffen School of Medicine University of California Los Angeles California USADavid Geffen School of Medicine University of California Los Angeles California USADavid Geffen School of Medicine University of California Los Angeles California USAAbstract Objective To evaluate the effects and outcomes of multidisciplinary surgical approaches in the management of carotid body tumors (CBT). Methods A single‐center retrospective study at the University of California—Los Angeles Medical Center was conducted on patients who presented with CBTs and underwent surgical resections from 1998 to 2020. Statistical analysis was performed using IBM SPSS v27 and Excel. Results A total of 75 patients with 79 CBT resections were included. Operating surgical subspecialties included: 41.8% vascular surgery, 24.1% otolaryngology head and neck surgeons (OHNS), and 31.6% combined OHNS and vascular. 68.4% of tumors underwent preoperative embolization. EBL was directly correlated with tumor size. CBT size was similar for OHNS (30 mm) and vascular (31 mm) but was significantly larger for combined OHNS and vascular cases (38 mm). EBL was higher in combined cases (301 mL) compared to OHNS (124 mL) or vascular (203 mL) alone. Incidence of postoperative cranial nerve deficits was 7.8%, with combined OHNS and vascular cases having an incidence of 4.0% when compared to OHNS (5.3%) versus vascular surgery alone (12.1%). Conclusion CBTs can be managed effectively by single surgical specialties with similar outcomes between vascular surgery and OHNS. In larger, higher grade tumors, however, a combined vascular and OHNS approach had lower incidence of postoperative cranial nerve injuries when compared to single specialty resections, despite a larger EBL. Thus, a multidisciplinary surgical approach suggests favorable outcomes with fewer incidence of cranial nerve deficits for larger, more complex CBT resections. Level of Evidence 2b—Individual retrospective cohort study.https://doi.org/10.1002/lio2.1130carotid body tumorsestimated blood lossparagangliomas |
| spellingShingle | Kirsten Wong Kenric Tam Eric K. Tran Dipti Sajed Maie St. John Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience Laryngoscope Investigative Otolaryngology carotid body tumors estimated blood loss paragangliomas |
| title | Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience |
| title_full | Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience |
| title_fullStr | Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience |
| title_full_unstemmed | Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience |
| title_short | Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience |
| title_sort | multidisciplinary care improves outcomes for patients with carotid body paragangliomas the ucla experience |
| topic | carotid body tumors estimated blood loss paragangliomas |
| url | https://doi.org/10.1002/lio2.1130 |
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