Surgical management of carotid body tumor experience in Zagazig University Hospital

Carotid body tumor is not a common disease, seldom put forth as the likely diagnosis in the case of upper neck swelling. This study was carried out on 8 patients [their ages ranged from 30-62 years [mean 42.9], 5 females and 3 males with carotid body tumor] who had attended the Surgical Outpatients Clinic, Zagazig University Hospital. Every patient was subjected to clinical evaluation, ultrasound, CT and carotid angiography. The results of the study revealed that the most common symptoms of these patients were neck mass [100%], hoarseness [12.5%] and dysphagia [12.5%]. The tumor was unilateral in all patients, the size of the tumor was less than 5 cm in 3 patients and greater than 5 cm in 5 patients. The mass was excised in all patients, subadvantetial resection in 5 patients and saphenous venous graft replacement in three patients. All specimens were benign [paraganglioma]. The postoperative neurological defect were hoarseness dysphagia and tongue deviation in three patients. It was concluded that surgery is an effective treatment for carotid body tumor. Early surgery was recommended because it minimizes the risk of complications associated with large size tumors

efficacy of fibrin sealant on post-operative seroma

Patients who have axillary dissection during modified radical mastectomy for breast cancer accumulate serosanginous fluid, potentially resulting in a seroma. Fibrin sealant is safe and effective when used as a sealing agent to reduce the duration and volume of seroma. Two groups of patients were r and omized, group I [10 patients] were treated by 2ml. fibrin sealant were sprayed onto the surgical site using double-barrel syringe. The wound were closed immediately allowing the fibrin sealant to seal the apposed tissues. Group II [10 patients] controlled group.The mean cumulative drainage for the first 4 post-operative days, in group I [324 +/- 58.6ml.] but in group II [616 +/- 83.4ml.]. The mean daily drainage from the first to fourth postoperative day were decreased by about 30% in group I but in group II about 15%. Mean drain removal time 5.8 +/- 1.6 and 9.3 +/- 1.7 days respectively in group I and II.The mean hospital stay 6.1 +/- 2.1 and 10.7 +/- 2.4 days respectively in group I and II. As regards to post-operative complications only drain clogged 10% in group I but 30% in group II, haematoma formation and skin necrosis occur only in group II [20%]. So fibrin sealant application following axillary dissection can significantly reduce the duration and quantity of seroma.