Abstract
We evaluated outcomes after carotid body tumor resection (CBR) requiring vascular reconstruction. Patients undergoing CBR at an academic medical center between 1990 and 2005 were identified. Medical records were retrospectively reviewed for clinical data, operative details, Shamblin’s classification, tumor pathology, complications, and mortality. Comparisons were performed between those undergoing CBR alone and CBR requiring vascular reconstruction (CBR-VASC). Of the 71 CBRs performed in 62 patients, 16 required vascular reconstruction (23%). Although there was no difference in mean tumor size (CBR 29.1 ± 11.9 mm, CBR-VASC 32.5 ± 9.9 mm; p = 0.133), carotid body tumors were more commonly Shamblin’s I when CBR was performed alone (CBR 53% vs. CBR-VASC 25%, p = 0.045) and Shamblin’s II/III when vascular reconstruction was required (CBR 47% vs. CBR-VASC 75%, p = 0.045). There was also a significant difference in malignant tumor pathology when vascular reconstruction was required (CBR 4.4% vs. CBR-VASC 25%, p = 0.034). Cranial nerve dysfunction was higher in patients requiring vascular repair (CBR 27% vs. CBR-VASC 63%, p = 0.012), but there was no difference in baroreflex failure (CBR 7.27% vs. CBR-VASC 0%, p = 0.351), Horner’s syndrome (CBR 5.5% vs. CBR-VASC 6.25%, p = 0.783), or first bite syndrome (CBR 7.27% vs. CBR-VASC 12.5%, p = 0.877). There were no perioperative strokes in either group, and one death was unrelated to operation. When required, carotid artery reconstruction at the time of CBR can be performed safely. Although cranial nerve dysfunction is more common when vascular repair is required, this is more likely related to locally advanced disease and tumor pathology rather than operative techniques.
Similar content being viewed by others
References
Luna-Ortiz K, Rascon-Ortiz M, Villavicencio-Valencia V, Herra-Gomez A. Does Shamblin’s classification predict postoperative morbidity in carotid body tumors? A proposal to modify Shamblin’s classification. Eur Arch Otorhinolaryngol 2006;263(2):171–175.
Luna-Ortiz K, Rascon-Ortiz M, Villavicencio-Valencia V, Granados-Garcia M, Herrera-Gomez A. Carotid body tumors: review of a 20-year experience. Oral Oncol 2005;41:56-61
Dardik A, Eisele DW, Williams GM, Perler BA. A contemporary assessment of carotid body tumor surgery. Vasc Endovascular Surg 2002;36:277-283
Patetsios P, Gable DR, Garrett WV, et al. Management of carotid body paragangliomas and review of a 30-year experience. Ann Vasc Surg 2002;16:331-338
Westerband A, Hunter GC, Cintora I, et al. Current trends in the detection and management of carotid body tumors. J Vasc Surg 1998;28:84-92
Hallett JW Jr, Nora JD, Hollier LH, Cherry KJ Jr, Pairolero PC. Trends in neurovascular complications of surgical management for carotid body and cervical paragangliomas: a fifty-year experience with 153 tumors. J Vasc Surg 1988;7:284-291
Wang SJ, Wang MB, Barauskas TM, Calcaterra TC. Surgical management of carotid body tumors. Otolaryngol Head Neck Surg 2000;123:202-206
Muhm M, Polterauer P, Gstottner W, et al. Diagnostic and therapeutic approaches to carotid body tumors. Review of 24 patients. Arch Surg 1997;132:279-284
Litle VR, Reilly LM, Ramos TK. Preoperative embolization of carotid body tumors: when is it appropriate? Ann Vasc Surg 1996;10:464-468
Netterville JL, Reilly KM, Robertson D, Reiber ME, Armstrong WB, Childs P. Carotid body tumors: a review of 30 patients with 46 tumors. Laryngoscope 1995;105:115-126
Plukker JT, Brongers EP, Vermey A, Krikke A, van den Dungen JJ. Outcome of surgical treatment for carotid body paraganglioma. Br J Surg 2001;88:1382-1386
Davidovic LB, Djukic VB, Vasic DM, Sindjelic RP, Duvnjak SN. Diagnosis and treatment of carotid body paraganglioma: 21 years of experience at a clinical center of Serbia. World J Surg Oncol 2005;3:10
Sniezek JC, Sabri AN, Netterville JL. Paraganglioma surgery: complications and treatment. Otolaryngol Clin North Am 2001;34:993-1006, vii
Shamblin WR, ReMine WH, Sheps SG, Harrison EG Jr. Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg 1971;122:732-739
Pellitteri PK, Rinaldo A, Myssiorek D, et al. Paragangliomas of the head and neck. Oral Oncol 2004;40:563-575
Gordon-Taylor G. On carotid body tumours. Br J Surg 1940;28:163-172
Maxwell JG, Jones SW, Wilson E, et al. Carotid body tumor excisions: adverse outcomes of adding carotid endarterectomy. J Am Coll Surg 2004;198:36-41
Kafie FE, Freischlag JA. Carotid body tumors: the role of preoperative embolization. Ann Vasc Surg 2001;15:237-242
Tripp HF Jr, Fail PS, Beyer MG, Chaisson GA. New approach to preoperative vascular exclusion for carotid body tumor. J Vasc Surg 2003;38:389-391
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Smith, J.J., Passman, M.A., Dattilo, J.B. et al. Carotid Body Tumor Resection: Does the Need for Vascular Reconstruction Worsen Outcome?. Ann Vasc Surg 20, 435–439 (2006). https://doi.org/10.1007/s10016-006-9093-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10016-006-9093-0