Incidence And Risk Factors Of Cranial Nerve Injury After Carotid Body Tumor Resection In Qinghai Area

Objective: To explore the incidence of cranial nerve injury and related risk factors after carotid body tumor resection in Qinghai area,and to provide some data supplement for the development of corresponding treatment plans for patients with carotid body tumor,so as to reduce the incidence of postoperative cranial nerve injury and improve the survival quality of patients.Methods: The medical records of patients with carotid body tumor who met the inclusion and exclusion criteria from January 2018 to January 2021 in the Department of Cardiovascular Surgery of the Affiliated Hospital of Qinghai University were collected and retrospectively analyzed.The patients were divided into cranial nerve injury group(CNI group)and non-cranial nerve injury group(non-CNI group)according to whether cranial nerve injury occurred after surgery.The general data(including gender,history of hypertension,ALB,Hb),preoperative imaging data(including Shamblin’s staging,tumor trophoblastic vessels,DTBOS,longitudinal diameter of tumor,CT volume of tumor),intraoperative data(including intraoperative bleeding volume,operating time grouping,number of lymph node dissection)and postoperative data(including WBC,incisional drainage)of the two groups were statistically analyzed.The statistically significant indexes were subjected to multi-factor logistic regression analysis,and the risk factors for the occurrence of CNI after carotid body tumor were finally derived.Results: A total of 87 patients with carotid body tumor who met the study criteria were included in this study,including 16 cases of bilateral lesions,39 cases of right-sided lesions,and 32 cases of left-sided lesions.87 patients were treated surgically,and 3 of the 16 patients with bilateral carotid body tumor were staged for bilateral resection,for a total of 90 cases of medical records data were subjected to final analysis.A total of 35 cases of CNI occurred after surgery,with an injury rate of38.89%.The results of univariate analysis showed that the differences between the CNI and non-CNI groups were statistically significant(P < 0.05)in terms of tumor CT volume,tumor longitudinal diameter,DTBOS,surgical time grouping,and intraoperative bleeding volume.The results of multifactorial logistic regression analysis showed that DTBOS was a protective factor for postoperative CNI,and each1-cm increase in DTBOS decreased the risk of CNI by 50.8%(OR=0.492,95% CI:0.267—0.906,P=0.023);Operative time was a risk factor for postoperative CNI,and the risk of CNI with an operative time of more than 150 minutes the risk of CNI was9.787 times higher for surgical time over 150 minutes than for surgical time less than90 minutes(OR=9.787,95% CI: 1.043—91.871,P=0.046).Conclusion: Surgical treatment remains the preferred method of carotid body tumor treatment,and the procedure is safe and reliable,but the incidence of postoperative CNI remains high.The incidence of postoperative CNI after carotid body tumor is associated with multiple factors,and DTBOS is a protective factor for the occurrence of CNI after carotid body tumor,while the duration of surgery is a risk factor for the occurrence of CNI after carotid body tumor thorough preoperative planning,multidisciplinary collaboration,adequate intraoperative field exposure,and shortened operative time can help reduce the incidence of postoperative CNI.