Clinical Outcome of Carotid Body Paraganglioma Management: A Review of 10-Year Experience

Background. Carotid body paragangliomas are rare neoplasms usually benign, however sometimes presenting as highly aggressive tumors. Surgery is the main line of treatment. Purpose. To study and describe clinical presentations, surgical approaches, postoperative complications, and treatment outcomes. Materials and Methods. A single-institution retrospective analysis of 19 cases with carotid body paragangliomas who were candidates for surgery from January 2009 through January 2019 with a mean follow-up period of 58.8 months. Results. The mean age was 46 years with the female predominance of 63%. The mean size of the tumor was 4.3 cm. All cases were presented with a painless pulsating neck lump located anteriorly at the level of the hyoid bone. Neck US was done in all cases as a primary screening investigation. CT scanning was the second main investigation performed in 17 cases (89.5%) revealing tumors attached to the carotid artery at its bifurcation. Urinary catecholamine metabolites were measured in all cases to rule out familial functioning types. 5 cases (26.3%) were malignant. All cases were surgically approached through transcervical transverse incision. 11, 5, and 3 cases were classified as Shamblin’s type II, III, and I, respectively. All tumors were R0 resected with nodal neck dissection conducted in the malignant group. Major complications occurred in 4 cases (21%) during tumor dissection from the adventitia of carotid bifurcation. ECA ligation was performed in one case (5.3%). 2 patients (10.5%) suffered XII nerve paralysis. Carotid artery blowout occurred in one patient (5.3%) and was immediately controlled. No operative mortality occurred. All patients were free of disease during the follow-up period. 4 malignant cases (21%) suffered a systemic relapse to bone and lung metastasis justifying adjuvant chemotherapy, radiotherapy, or both. Conclusions. Surgery is the treatment of choice for carotid body paragangliomas. Complete R0 resection should be justified especially in case of malignancy. Adjuvant chemotherapy or radiotherapy is an option for patients with primary malignancy or relapse

Mansoura conventional electrophysiological study and ablation registry at time between march 2020 to march 2021

Background: Catheter ablation has been described as a standard therapy for cardiac tachyarrhythmias. Although multiple registries have been reported from different geographical regions, like Europe and the USA, little is known about the criteria and outcomes of such patients in the Egyptian setting. Herein, we report the distribution of cardiac arrhythmias, success rate, and complications of catheter ablation in our tertiary care cardiac setting. Methods: This prospective cross-sectional study included 50 patients who underwent catheter ablation for cardiac tachyarrhythmias. Results: Most patients were older than 40 years (62%). Our study revealed the following types of arrhythmias; atrioventricular reciprocating tachycardia (AVRT) (30%), atrioventricular nodal reentry tachycardia (AVNRT) (48%), atrial tachycardia (4%), Wolff-Parkinson-White syndrome (12%), and atrial flutter (6%). Decremental retrograde conduction was noted in 62% of patients, while non-decremental conduction was present in 38% of them. A slow pathway was ablated in most patients (48%), while other ablated areas included the upper and lower crista terminalis (4%), posterior septum (10%), lateral annulus either right or left one (26%), anterior septum (2%), mid septum (4%), and cavotricuspid isthmus (6%). Our general success rate was 98%. AVNRT was significantly associated with older age, as 67.7% of their patients were older than 40 years.&nbsp