Surgical management of carotid body tumor - 20 years experience

Abstract

AIM: The study aims to review surgical management of carotid body tumors (CBTs). METHODS: All patients with CBTs underwent surgical resection during the period 1.1.1994 till 1.1.2014 in Queen Mary Hospital were retrospectively reviewed. Their presentation, operative details, postoperative complications as well as follow up information were reported. RESULTS: 20 patients (4 males and 16 females) with 21 CBT operations were recorded. Median age was 36 (range 21–58). All except two CBTs presented as neck mass; one was incidental finding on CT scan and another presented as facial nerve palsy. 6 CBTs (28.6%) were Shamblin class I, 10 (47.6%) were class II and 5 (23.8%) were class III. Two operations required ICA resection and reconstruction to facilitate tumor removal. 4 resections were subtotal, while 17 achieved completion resection. Complications included 2 major strokes, 3 hoarseness of voice and 2 temporary Horner’s syndrome. Shamblin class predicted operative time, blood loss and whether complete resection accomplished (mean operative time 139 minutes, 279 minutes and 396 minutes, p = 0.04; mean blood loss 53 ml, 478 ml and 1500 ml, p < 0.001; complete resection in 6/6 (100%), 9/10 (90%) and 2/5 (40%) for class I, II and III respectively, p = 0.025), but could not predict complication (complications occurred in 2/6 (33%), 3/10 (30%) and 1/5 (20%) of class I, II and III respectively, p = 0.88). With 94 months median follow up, no tumor recurrence was found in all 16 patients whom complete resection achieved. CONCLUSION: Close proximity of the tumor to major carotid vessels and nerves incurred significant operative morbidities. Shamblin class would predict operative difficulty but not complication.