T10-2A OPERATIVE REPORT, EXCISION OF CAROTID BODY TUMOR
INDICATIONS FOR SURGERY: The patient is a 67-year-old Caucasian female who was found to have a mass in her right neck on CT (computerized tomography) scan. Angiography was done, and this showed the mass in the area of the bifurcation of the internal and external carotid artery, consistent with a carotid body tumor. The patient was taken to the operating room for excision.
PROCEDURE: The patient was prepped and draped in the usual manner. A right neck incision was made on the anterior border of the sternocleidomastoid muscle. Dissection was carried down to the common carotid artery. The facial vein was ligated with 0 silk suture doubly ligated on each end before division. There were a couple of other small veins that were ligated with real silk sutures and divided. The common carotid artery was then dissected free from surrounding tissues, and a vessel loop was placed around the artery in a figure-of-eight fashion. Dissection was then carried up onto the external carotid artery, and the external carotid artery was isolated with a vessel loop. The next two branches off the external carotid artery were also isolated. The internal carotid artery was dissected out and also isolated with a vessel loop. The hypoglossal nerve was identified and dissected and retracted superiorly. Next, the tumor was approached by dissecting along the external carotid artery and taking all the small vessels that entered into the tumor. The vessels were ligated with 3-0 and 4-0 silk sutures and divided. After this was done, the dissection was carried out on the internal carotid artery, and this dissection was also carried superiorly. Finally, the superior-most pole was the only thing remaining; a small segment was left and was clamped with a right-angle clamp, and the tumor was released from the superior pole. The right-angle clamp tissue was tied with 0 silk suture and doubly ligated, and the clamp was removed. The dissection was carried down proximally, and there was what appeared to be a nerve entering the carotid body tumor at the base. Photographs were taken of the carotid body tumor during the operative procedure. The final attachment was then clamped, divided, and tied with 2-0 silk suture. The specimen was sent for frozen section. Frozen section returned the diagnosis of carotid body tumor. The operative area was thoroughly irrigated. Hemostasis was complete. The incision was then closed in layers using running 3-0 Vicryl suture for the platysma and a 4-0 Vicryl subcuticular stitch for the skin. Steri-Strips were applied. The patient tolerated the operation and returned to recovery in stable condition.
PATHOLOGY REPORT LATER INDICATED: See T10-2B.
T10-2A:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________

Question

T10-2A OPERATIVE REPORT, EXCISION OF CAROTID BODY TUMOR
  INDICATIONS FOR SURGERY: The patient is a 67-year-old Caucasian female who was found to have a mass in her right neck on CT (computerized tomography) scan. Angiography was done, and this showed the mass in the area of the bifurcation of the internal and external carotid artery, consistent with a carotid body tumor. The patient was taken to the operating room for excision.
PROCEDURE: The patient was prepped and draped in the usual manner. A right neck incision was made on the anterior border of the sternocleidomastoid muscle. Dissection was carried down to the common carotid artery. The facial vein was ligated with 0 silk suture doubly ligated on each end before division. There were a couple of other small veins that were ligated with real silk sutures and divided. The common carotid artery was then dissected free from surrounding tissues, and a vessel loop was placed around the artery in a figure-of-eight fashion. Dissection was then carried up onto the external carotid artery, and the external carotid artery was isolated with a vessel loop. The next two branches off the external carotid artery were also isolated. The internal carotid artery was dissected out and also isolated with a vessel loop. The hypoglossal nerve was identified and dissected and retracted superiorly. Next, the tumor was approached by dissecting along the external carotid artery and taking all the small vessels that entered into the tumor. The vessels were ligated with 3-0 and 4-0 silk sutures and divided. After this was done, the dissection was carried out on the internal carotid artery, and this dissection was also carried superiorly. Finally, the superior-most pole was the only thing remaining; a small segment was left and was clamped with a right-angle clamp, and the tumor was released from the superior pole. The right-angle clamp tissue was tied with 0 silk suture and doubly ligated, and the clamp was removed. The dissection was carried down proximally, and there was what appeared to be a nerve entering the carotid body tumor at the base. Photographs were taken of the carotid body tumor during the operative procedure. The final attachment was then clamped, divided, and tied with 2-0 silk suture. The specimen was sent for frozen section. Frozen section returned the diagnosis of carotid body tumor. The operative area was thoroughly irrigated. Hemostasis was complete. The incision was then closed in layers using running 3-0 Vicryl suture for the platysma and a 4-0 Vicryl subcuticular stitch for the skin. Steri-Strips were applied. The patient tolerated the operation and returned to recovery in stable condition.
PATHOLOGY REPORT LATER INDICATED: See T10-2B.
T10-2A:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________

Quizplus · Accepted Answer

The Answer of T10-2A OPERATIVE REPORT, EXCISION OF CAROTID BODY TUMOR
  INDICATIONS FOR SURGERY: The patient is a 67-year-old Caucasian female who was found to have a mass in her right neck on CT (computerized tomography) scan. Angiography was done, and this showed the mass in the area of the bifurcation of the internal and external carotid artery, consistent with a carotid body tumor. The patient was taken to the operating room for excision.
PROCEDURE: The patient was prepped and draped in the usual manner. A right neck incision was made on the anterior border of the sternocleidomastoid muscle. Dissection was carried down to the common carotid artery. The facial vein was ligated with 0 silk suture doubly ligated on each end before division. There were a couple of other small veins that were ligated with real silk sutures and divided. The common carotid artery was then dissected free from surrounding tissues, and a vessel loop was placed around the artery in a figure-of-eight fashion. Dissection was then carried up onto the external carotid artery, and the external carotid artery was isolated with a vessel loop. The next two branches off the external carotid artery were also isolated. The internal carotid artery was dissected out and also isolated with a vessel loop. The hypoglossal nerve was identified and dissected and retracted superiorly. Next, the tumor was approached by dissecting along the external carotid artery and taking all the small vessels that entered into the tumor. The vessels were ligated with 3-0 and 4-0 silk sutures and divided. After this was done, the dissection was carried out on the internal carotid artery, and this dissection was also carried superiorly. Finally, the superior-most pole was the only thing remaining; a small segment was left and was clamped with a right-angle clamp, and the tumor was released from the superior pole. The right-angle clamp tissue was tied with 0 silk suture and doubly ligated, and the clamp was removed. The dissection was carried down proximally, and there was what appeared to be a nerve entering the carotid body tumor at the base. Photographs were taken of the carotid body tumor during the operative procedure. The final attachment was then clamped, divided, and tied with 2-0 silk suture. The specimen was sent for frozen section. Frozen section returned the diagnosis of carotid body tumor. The operative area was thoroughly irrigated. Hemostasis was complete. The incision was then closed in layers using running 3-0 Vicryl suture for the platysma and a 4-0 Vicryl subcuticular stitch for the skin. Steri-Strips were applied. The patient tolerated the operation and returned to recovery in stable condition.
PATHOLOGY REPORT LATER INDICATED: See T10-2B.
T10-2A:
SERVICE CODE(S): ___________________________________________________
ICD-10-CM DX CODE(S): ______________________________________________