Carotid body tumors: challenging complexity of diagnosis and surgical treatment.

OBJECTIVES To evaluate the patients treated for carotid body tumors and the problems encountered during diagnosis and treatment. PATIENTS AND METHODS The study included eight patients (5 females, 3 males; mean age 50 years; range 36 to 68 years) who underwent surgery for carotid body tumors. Diagnosis was confirmed by power Doppler ultrasonography and computed tomography or magnetic resonance imaging in all patients. Angiography was performed in three patients to evaluate vascularity and to perform embolization before surgery. Two patients had previously undergone biopsy elsewhere. The mean follow-up was 15 months (range 2 to 36 months). RESULTS The size of the tumors varied from 3 cm to 11 cm. In two patients the tumors were found to extend to the skull base. Ligation of the external carotid artery and the common carotid artery was performed in five patients and in one patient, respectively. Surgery-associated injuries given to the internal carotid artery in two patients were repaired by sutures. The 10th cranial nerve was dissected in two patients who had undergone a prior biopsy. They developed cord paralysis and hoarseness postoperatively. Resection of the 11th cranial nerve in one patient resulted in shoulder pain and drop shoulder. The 12th cranial nerve was repaired end-to-end by neurorrhaphy in two patients. They exhibited significant improvement in nerve functions a year after surgery. CONCLUSION The larger the tumor is, the more difficult the resection is, and the more injuries are caused to the surrounding nerves and vessels.