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Surgery with Local Anesthesia to the Tumors of the Carotid Artery

Carotid artery tumors, which are a rare condition can result in hoarseness, dyspnoea and rarely, partial paralysis because of the fact that the carotid arteries are close to the vena that lead to the brain. There are three types of carotid artery tumors. As misplaced tumors, they are classified as type 1 which we define as the simple type that is not adherent to the vein, type 2 that wraps the vein 180 degrees and type three that wraps the vein 360 degrees. Tthese type of tumors is usually benign. They must be removed because of the region they are located in  as it  is being a sensitive area  close to the tongue, vocal cords, trachea and and to the area where the carotid arteries and the vena that lead to the brain are located.  Therefore, we can describe the tumors located here as time bombs.

Sometimes they don’t show any symptoms at all.

In addition to hoarseness and dyspnoea, they can also cause difficulties in swallowing, a mass in the neck or a feeling of extra weight in the neck but additionally they can also progress without any symptoms. There are tumors that can grow to 15 centimeters and show no symptoms or do not show their presence at all but we can also talk about tumors of 3-4 centimeters which show themselves.  As a result, regardless of the size of the tumor, this type of tumor must be removed as per the region they are located. The otolaryngologist diagnoses the tumors of carotid arteries. Therefore, as encountering the symptoms, an otolaryngologist must be consulted immediately.

The carotid artery tumor must be removed as soon as it is seen.

Around the carotid artery there are the nerves that move our tongue, the nerves that move our face, the nerves that provide our voice, the brain vena, our trachea and our esophagus. When carotid artery tumors grow, they enact pressure in these regions. If you do not respond correctly to this mass on time, the mass can grow very large and suffocate the patient to death, paralyze them, create voice paralysis and create unwanted facial curvatures. For this reason, carotid artery tumors must be removed as soon as they are noticed.

Local anesthesia minimises the risks of the surgery.

Firstly, we routinely administer local anesthesia to patients with Type 1 and Type 2 tumors. These operations are among the first in Turkey and in the World. In the following period, we think that Type 3 patients can also participate in this. Aside from the standard risks in surgeries conducted under general anesthesia, in carotid artery tumor surgeries, there is also a risk of damage to the nerves in the face and the neck. The operation carries many risks, for example if it affects the facial nerves there is a risk of facial tension or facial paralysis. If it affects the vocal nerves, there is a risk of hoarseness and if it affects the carotid artery, there is a risk of stroke. And if a nerve injury happens accidentally, this may cost the patient’s life. In local anesthesia, as the tumor is removed, the patient becomes uncomfortable. They start to cough or feel severe pain. And we take measures accordingly. We remove the tumor without touching the nerve from above or below. In addition, another important point is that a lot of serious problems can occur in carotid artery tumors under general anesthesia. We have not encountered such problems with local anesthesia. The surgery takes approximately 1 hour. The patient is taken to the normal room without intensive care and they are discharged in a day or two.

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