Rutherford's 098: Carotid Body Tumors скачать в хорошем качестве

Rutherford's 098: Carotid Body Tumors

#CarotidBodyTumors #CBT #VascularSurgery #NeckMass #Paraganglioma #StrokePrevention #RareTumors #Diagnosis #Treatment #SurgicalResection #Rutherfords Drawing from Rutherford's Vascular Surgery textbook, this video details Carotid Body Tumors (CBTs), rare neoplasms arising from the carotid body. The carotid body, located at the carotid artery fork, is the body's largest chemoreceptor, sensing oxygen, CO2, and pH levels, signaling the brain to regulate breathing and blood pressure. CBTs are historically rare, making consensus on management difficult. They are classified as sporadic (most common), familial (linked to SDHD gene mutations, often bilateral, presenting younger), or hyperplastic (associated with chronic hypoxia like high altitude or lung disease). Peak diagnosis is 30s-50s. The most common symptom is a painless, movable neck mass just below the jaw angle that is fixed vertically. Larger tumors can cause nerve symptoms like hoarseness or difficulty swallowing. While often benign microscopically, malignancy is defined by local invasion or metastasis to lymph nodes or distant sites. Diagnosis relies on imaging. CTA or MRA are preferred over historical angiography for their non-invasive detail. Duplex ultrasound is useful for follow-up. Needle biopsy is strongly discouraged due to the high risk of severe bleeding or injury. The Shamblin classification grades tumor involvement with the carotid arteries, aiding surgical planning. Early surgical resection is the standard treatment, aiming to remove the tumor when smaller for lower complication risk and to prevent local invasion or unpredictable malignancy. Radiation's role is debated; it may slow growth but doesn't shrink tumors and can complicate later surgery. Preoperative embolization is also controversial. Surgery carries risks like bleeding (a major concern due to vascularity) and cranial nerve injury, which is more likely with larger tumors but often temporary. Outcomes in experienced centers are generally excellent with low mortality and major complication rates. Long-term follow-up is recommended.