Bengaluru: The Indian Journal of Surgical Oncology has an interesting submission made in the field of carotid body tumour surgery. City based oncologist Dr U.S. Vishal Rao, a head and neck surgeon at HCG, recently operated a 38-year-old patient from Tumakuru district who was suffering from a rare carotid body tumour.
Apart from its peculiarity, the tumour was also the largest size ever presented to the oncologist.
“It was by far the largest size presented to us or reported literature. It was 10 cm, extending from neck to base of skull completely encircling the blood vessels that supply blood to neck and brain. Its positioning was such that a wrong surgery could lead to a permanent damage or stroke,” explained Dr Vishal. A case which is more commonly seen among mountaineers for lack of oxygen, however, affected the patient for unknown reasons. The patient had, however, walked in for surgery, not at the onset but had waited for some 2-3 years assuming it to settle down.
“In his case though the tumour had rapidly increased in size and touched the base of the skull. That's when he got alarmed," the doctor added. Since the patient was covered under the ESI scheme, the doctors from ESI hospital had also come to observe the surgery. The doctors had various techniques to perform the surgery and, among them, the common technique is to dissect the carotid body tumour to address the external carotid artery at the initial steps of the surgery.
The dissection is usually initiated from the common carotid artery, and then, the tumour is dissected off the external carotid artery. The internal carotid artery is dissected towards the final step after the external carotid artery is freed of a tumour.
“However, we went ahead with the technique which is considered difficult but is more fruitful. We started with internal carotid artery (ICA) dissection. It saves time and the surgery gets faster,” added Dr Vishal....