¹Vascular Surgery Unit, Department of General Surgery, Al-Thawra Modern General Hospital, Sana’a City, Yemen

²Vascular Surgery Unit, Al-Thawra Modern General Hospital, Sana’a City, Yemen

³Master of Epidemiology, and Biostatistics, District Sales Manager at Shaphaco Pharmaceutical Industries, Sana’a City, Yemen

⁴Consultant of Vascular Surgery M.D, Republican Hospital, University of Science and Technology Hospital, Sana’a City, Yemen

⁵Master of Oral Surgery and Dental Implantology, University of Science and Technology, Sana’a City, Yemen

*Corresponding Author: Abdulhafeedh Al-Habeet, Master of Epidemiology, and Biostatistics, District Sales Manager at Shaphaco Pharmaceutical Industries, Sana’a City, Yemen; Email: [email protected]

Received Date: July 16, 2023

Publication Date: August 01, 2023

Citation: Almadwahi N, et al. (2023). Surgical Management of Carotid Body Tumors: A Triple Center Retrospective Study in Sana’a City, Yemen. Mathews J Surg. 6(3):21.

DOI: https://doi.org/10.30654/MJS.10021

ABSTRACT

Context and Objective: Carotid body tumors (CBTs) are the most common paragangliomas of the head, and neck, accounting for 80% of cases. Although their symptoms are minor, these tumors deserve special attention in order to reach an accurate diagnosis, and appropriate treatment. In the past decades, interest in studying these tumors has increased; however, apparently no published research has been conducted in Yemen. Therefore, we included the largest three hospitals in Sana’a City, Yemen discussing the sociodemographic features of patients, diagnosis challenges, surgical intervention, and complications of surgical procedures. Patients and Methods: Over a period of 4.5 years from January 2018 to June 2022, a retrospective study was conducted to identify cases of CBTs in patients who underwent surgical treatment of pathologically confirmed CBTs at the vascular surgery unit, department of general surgery in the three largest hospitals in Sana’a City, Yemen. We relied on the hospital charts to review the data on sociodemographic, perioperative, and surgical complications. CBT measurements were determined from preoperative magnetic resonance angiography, computed tomography, and ultrasound examinations of the neck. Shamblin’s classification system was used to categorize CBTs based on their size and the challenge of the surgical removal. Results: Fifty-three CBTs were resected from 48 cases (42 women and 6 men; female:male ratio of 7:1). The age of the cases at presentation varied from 28 to 61 years (the mean age was 45 ± 11.6 years). The majority of cases (77%) were from mountainous areas with an altitude of more than 2000 meters above sea level. The recurrence rate was 4.2% (2 cases). All cases were malignant and presented with a neck lump (100%), whereas 27 (56.7%) cases presented with disfigurement. Right-side tumors were in 19 (39.6%) cases, left-side tumors were in 24 (50%) cases, and bilateral tumors were in 5 (10.6%) cases. The distribution of cases in Champlin classes (I), (II), and (III) was 7 (14.7%), 27 (56.7%), and 14 (29.4%), respectively. The incidence of postoperative cranial nerve deficit (POCND) was about 17% in 8 cases. No strokes or mortality were recorded. Conclusion: Despite the inclusion of the three largest hospitals in Sana'a City along with the relatively long study period, CBTs are still rare neoplasms. In our experience, CBTs are predominantly tumors of middle age and more common in women, suggesting that we could be dealing with a different disease in Yemeni population, especially among those who dwell in the highlands. The experience of this casuistry shows that the surgical resection is relatively low-risk and the incidence of POCND was small.

Keywords: Carotid Body Tumors, Carotid Chemodectoma, Paragangliomas, Neoplasms, Head and neck surgery, Sana’a City, Yemen