A new potential risk factor for permanent cranial nerve injury following carotid body tumor resection

Dihao Wen; Jian Zhou; Yu Li; Jiang Zhu; Shiying Wang; Chao Song; Wei Yin; Zijun Jia; Xiatian Zhu; Xiaolong Wei; Zhiqing Zhao; Yudong Sun

doi:10.21037/qims-22-464

A new potential risk factor for permanent cranial nerve injury following carotid body tumor resection

Quant Imaging Med Surg. 2023 Jan 1;13(1):384-393. doi: 10.21037/qims-22-464. Epub 2022 Nov 7.

Authors

Dihao Wen^#^{1

2}, Jian Zhou^#^{2

3}, Yu Li^#², Jiang Zhu², Shiying Wang², Chao Song², Wei Yin⁴, Zijun Jia⁴, Xiatian Zhu², Xiaolong Wei², Zhiqing Zhao², Yudong Sun⁵

Affiliations

¹ Department of General Surgery, The 980th Hospital of the PLA Joint Logistics Support Force (Primary Bethune International Peace Hospital of PLA), Shijiazhuang, China.
² Department of Vascular Surgery, Changhai Hospital, the PLA Naval Medical University, Shanghai, China.
³ Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai, China.
⁴ Department of Medical Imaging, Changhai Hospital, The PLA Naval Military Medical University, Shanghai, China.
⁵ Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

^# Contributed equally.

Abstract

Background: To quantify the association between the free distal segment length of the internal carotid artery (FDS-ICA) and permanent cranial nerve injury (p-CNI) following carotid body tumor (CBT) resection.

Methods: This study is a case-control study. We surveyed 109 consecutive patients who underwent CBT resection between June 2015 and June 2020 at our single center. A total of 89 patients met the inclusion criteria and were selected for analysis. The FDS-ICA was measured by image post-processing software for computed tomography angiography (CTA). Postoperative p-CNI complications were evaluated using comprehensive statistical approaches.

Results: The cohort was divided into 2 groups depending on the presence of p-CNI, namely the p-CNI group (n=17) and the non-CNI group (n=79). The average FDS-ICA of patients with p-CNI complications was shorter than that of those without p-CNI complications (P<0.001). For every 1 mm increase in FDS-ICA, there was an associated decrease of 8% in the risk of p-CNI (0.92, 95% CI: 0.85 to 0.98, P<0.05). Threshold effect analysis of the FDS-ICA on p-CNI identified that the FDS-ICA was 28.7 (95% CI: 23.8 to 30.9) mm.

Conclusions: The results of this study revealed a significant independent association between FDS-ICA and permanent postoperative cranial nerve injury complications of CBTs. Further study is warranted to confirm these results in a larger patient cohort.

Keywords: Carotid body tumor (CBT); free distal segment length of internal carotid artery (FDS-ICA); permanent cranial nerve injury (p-CNI); surgical resection.