Medizinische Universität Graz - Research portal
Selected Publication:
Ivanjko, F.
Distance to the Base of Skull (DTBOS): Significance of the new predictor regarding perioperative surgical complications of carotid body tumor resections- a retrospective analysis
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2021. pp. 64
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- Authors Med Uni Graz:
- Advisor:
- Cohnert Tina Ulrike
- Konstantiniuk Peter
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- Abstract:
- Carotid body tumors (CBTs) are rare neuroendocrine neoplasms located at the carotid bifurcation. Therapeutic gold standard is the tumor resection. The most frequent complication in patients undergoing carotid body tumor resections are injuries of the cranial nerves. Goal- The primary aim of this study is to investigate the impact of the newly developed DTBOS (distance to the base of skull), regarding prediction of perioperative cranial nerve (CN) injuries compared to the Shamblin classification. Correspondingly, this work also reflects on the significance of variables, including morphological parameters. Relevant parameters aid in the preoperative information and consent of a patient before their carotid body tumor resection as well as support the surgical team in deciding upon precautionary measures. Design/Methodology- The dissertation analyzes data from 2004 to 2019 in a retrospective study. Patients undergoing elective surgery for carotid body tumor at Graz Medical University and presenting complete medical data records were analyzed. By medical imaging (Magnetic Resonance Tomography or Computed Tomography), tumor-specific parameters such as DTBOS and diameter were determined. The significance of DTBOS, Shamblin Classification and other parameters was analyzed with univariate logistic regression analysis. Univariately significant parameters were analyzed in a multivariate model. Results- There was a total of 93 cases, 47 cases were included and 46 had to be excluded from the study. Forty-two cases were excluded because of a lack of medical imaging, two were excluded as a result of incidental findings, one was excluded because the paraganglioma location was not located at the carotid bifurcation, and one case was excluded since the patient did not undergo surgery. In the univariate analysis four univariately significant parameters were detected; body weight (p=0.046), DTBOS (p=0.009), craniocaudal tumor diameter (p=0.027) and volume of tumor (p=0.036). In the multivariate calculation only DTBOS (p=0.046) remained significant. In conclusion, DTBOS is currently the best parameter regarding preoperative risk assessment of CN injuries. Clinical values and benefits- The established results of this dissertation reveal, that the parameter DTBOS supports surgeons and patients to grow a deeper understanding for the respective medical issue and can aid in taking preoperative precautions. Limitations – On the basis of the infrequent appearance of a carotid body tumor, the surgical cadre of the Medical University of Graz perform on average three carotid body tumor resections per year. Additionally, a relevant number of data had to be excluded from this degree dissertation, as the medical imaging could not be retrieved.