Surgical management of carotid body tumors: A 15-year review

Objective: To study the distribution and treatment results of p tients with carotid body tumors (CBT). Design: Retrospective study. Setting: Tertiary care center, South India. Materials and Methods: Nineteen patients with carotid body tumors seen over the last 15 years of whom 16 were operated upon. Outcomes: Operating time, intraoperative blood loss, in-hospital morbidity and mortality and recurrence at one year were studied. Results: Of the 19 patients studied, 16 were operated upon of whom two developed postoperative cranial nerve palsies. Careful subadventitial dissection was used for all patients, however, with better techniques over the years the results, in terms of blood loss and operating time, have improved. External carotid artery was ligated in seven patients. One patient needed repair of the common carotid artery and another needed temporary shunting and reanastomosis for injury to the proximal internal carotid artery. Two patients had preoperative embolization of the tumor. One of these patients did better than the other in terms of operating time and blood loss. At one-year follow-up, no recurrences were noted. Conclusions: Excision of a CBT is recommended at the time of initial diagnosis in patients in good general health to avoid the difficulty of subsequent excision of an enlarging and highly vascular tumor with possible encasement of the carotid arteries. Meticulously subadventitial dissection and excision is the key to achieve complete excision with minimal morbidity. This method should therefore be used for the excision of CBT. Facilities for shunting and arterial repair should always be available.