Surgical Removal of the Carotid Body and its Relation to the Carotid Chemoreceptor and Baroreceptor Reflex in Asthmatics

¹ Nippon Zoki Institute for Constitutional Diseases

1. Asthmatics generally have a hyperactive carotid body (chemoreceptor) and carotid sinus (baroreceptor). The hyperactivity of both the reflexes, especially during the attack period, enhances pulmonary vagotonia.

2. Although glomectomy often gives good temporary effect on asthma, the attacks usually recur sooner or later. This is but natural, because pulmonary vagotonia is too stubborn to be subdued by surgical treatment alone.

3. By glomectomy, the carotid sinus nerves may be injured more or less. Likewise, by the removal of the carotid sinus nerves and aortic nerves, the nerves of the chemoreceptor nerves may be injured more or less.

4. The effect of glomectomy is ascribed chiefly to the removal of mechanical stimulation of the irritable bronchial walls of asthmatics caused by rapid and deep respiration due to the chemoreceptor reflex also, partly to the heightening of irritability of the cardiac vagus that antagonistically lowers that of the pulmonary vagus, and finally, partly to the injury of the carotid sinus nerves that weakens more or less the pulmonary vagotonia.

5. Since both the above reflexes exert unfavorable effects upon the irritable bronchial walls, it is better for the treatment of asthma to remove both the carotid bodies and the carotid sinus nerves.

6. Asthmatic attacks usually recur sooner or later even in the apparently cured cases following the above treatments. Therefore, such surgical treatments may be recommended only for patients who have hyperactive carotid body and carotid sinus.

7. For utilization of such treatment for cure of asthma, more emphasis should be placed upon the prevention of recurrence that follows treatment than to the relief of asthmatic attacks.