60600 Excision of carotid body tumor; without excision of carotid artery

Name of the Procedure:

Excision of Carotid Body Tumor; Without Excision of Carotid Artery
Common names: Carotid Body Tumor Removal, CBT Excision

Summary

The excision of a carotid body tumor is a surgical procedure to remove a growth located at the bifurcation (split) of the carotid artery in the neck. This procedure avoids removing parts of the carotid artery itself, focusing only on the tumor.

Purpose

This procedure addresses the presence of a carotid body tumor, which can cause symptoms like difficulty swallowing, a noticeable lump in the neck, and high blood pressure due to the tumor pressing on surrounding structures. The primary goal is to remove the tumor while preserving the integrity of the carotid artery.

Indications

• A palpable lump in the neck near the carotid artery
• Symptoms such as dizziness, difficulty swallowing, or high blood pressure
• Confirmed diagnosis of a carotid body tumor through imaging studies
• No significant medical conditions that would contraindicate surgery

Preparation

• Fasting for 8 hours before the procedure
• Discontinuing certain medications like blood thinners, as advised by the surgeon
• Preoperative imaging tests such as CT scans or MRIs to map the tumor location
• Blood tests to ensure suitable levels of clotting factors and overall health

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the neck to access the tumor.
3. Surrounding tissues are carefully dissected to expose the carotid body tumor.
4. The tumor is meticulously separated and removed without disturbing the carotid artery.
5. The incision is closed with sutures or staples, and a drainage tube may be placed to prevent fluid buildup.
6. The patient is moved to a recovery area to be monitored as the anesthesia wears off.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity and size of the tumor.

Setting

This procedure is most commonly performed in a hospital or a surgical center equipped with advanced imaging and monitoring facilities.

Personnel

• Vascular Surgeon or Head and Neck Surgeon
• Surgical Nurses
• Anesthesiologist
• Operating Room Technicians

Risks and Complications

• Common risks: Infection, bleeding, and temporary nerve damage
• Rare risks: Stroke, permanent nerve damage (leading to issues like vocal cord paralysis), or complications from anesthesia
• Management involves close monitoring and prompt intervention if complications arise.

Benefits

• Removal of the tumor, alleviating symptoms and preventing potential complications like increased blood pressure.
• Preservation of the carotid artery, reducing the risk of stroke or other major vascular issues.
• Most patients experience significant symptom relief shortly after recovery.

Recovery

• Initial recovery involves a hospital stay of 1-2 days for monitoring.
• Instructions typically include wound care, avoiding strenuous activities, and follow-up appointments to check on healing and remove any drainage tubes.
• Most patients can return to normal activities within a few weeks but should follow specific restrictions as advised by their surgeon.

Alternatives

• Observation and regular monitoring for small, asymptomatic tumors
• Radiation therapy, though it may not be as effective and carries its own risks
• Endovascular treatments, though less common and not typically first-line due to the tumor's location
• Pros: Less invasive alternatives may reduce immediate risks.
• Cons: May not provide as definitive treatment as surgical excision.

Patient Experience

During the procedure: The patient will be under general anesthesia and will not feel pain. Post-procedure: Expect some soreness in the neck, manageable with prescribed pain medication. Many patients report noticeable relief from symptoms soon after surgery. Regular follow-up visits will ensure proper recovery and management of any unexpected issues.