GLOMECTOMY FOR ASTHMA.

N Y State J Med

Published: December 1963

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Unlabelled: The main causes of neurally mediated syncope (NMS) are carotid sinus syndrome (CSS) and vasovagal syncope. Long before, carotid sinus denervation was performed for different diseases, but for the first time we consider glomectomy (G) as a surgical treatment for NMS and related arrhythmias, alone or associated with cardiac pacing (PM).

Methods: We used Nakayama's technique for bronchial asthma, modified by us: removal of hypersensitive carotid glomus and presinusal lymphadenectomy.

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Methods of surgical treatment of bronchial asthma (BA) are classified as first generation (glomectomy, gangliectomy, vagotomy, pulmonary roots denervation), second generation (implantation of neurostimulators of sinocarotid, diaphragmal nerves, vagus, sympathic trunks), third generation (implants of programmed microchips). 7-year experience of surgical treatment with second generation methods in 125 patients with BA and experience of third generation methods use are summarized. Methods of second and third generations are most promising, permit to prevent and to cure asphyxia attack without drugs--with electrostimulation of vegetative system structures by impulse current (30-150 Hz, 0.

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Thirty-year experience in surgical treatment of more than 3,000 patients with severe and moderately severe bronchial asthma showed that unilateral glomectomy produces a stable positive result in 69.5% of patients in follow-up repiods of two and more decades. Clinical recovery occurred in 23.

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The carotid bodies in bronchial asthma.

Histopathology

March 1991

Institute of Pathology and Histopathology, University of Pisa, Italy.

A histological study was made of right-sided carotid bodies resected therapeutically from 50 patients with bronchial asthma. Also studied as controls were 10 right-sided carotid bodies from subjects coming to necropsy. Hypoxaemia was considered a contra-indication to glomectomy and only patients with a resting arterial oxygen tension exceeding 65 mm Hg were submitted to operation.

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