Open AccessVanderbilt’s Experience with 201 Carotid Body Tumors
Author(s) -
Netterville James L.,
Kuwada Clinton A.,
Schmalbach Cecelia E.,
Zender Chad A.,
Van Deusen Mark B.,
Athavale Sanjay,
Sinard Robert J.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a109
Subject(s) - medicine , carotid body , paraganglioma , surgery , otorhinolaryngology , retrospective cohort study , embolization , carotid arteries
Objective To discuss the evolving treatment considerations of carotid body tumors (CBT) based on a large cohort. Method A retrospective review of 149 patients with 201 CBT treated at Vanderbilt University’s Dept. of Otolaryngology over a 25‐year period (1986‐2011). Patients were analyzed for preoperative deficits, familial involvement, progression under observation, operative details, and postoperative sequelae. Results Bilateral CBTs were identified in 44%, associated vagal paragangliomas in 26%, and jugular tumors in 22% of patients. Familial inheritance was noted in 35%. A total of 163 tumors were resected from 139 patients. Preoperative embolization was utilized in 33% of tumors. Internal carotid resection‐reconstruction was performed in 13%. No postoperative strokes occurred. Postoperative cranial nerve dysfunction was rare. Of patients who underwent staged resection of bilateral CBTs, 73% experienced baroreflex failure. Although transient mild first bite syndrome was common, only 30% of patients had ongoing significant symptoms. No recurrence has been noted from the CBTs resected at Vanderbilt. Conclusion Management of CBTs requires consideration of familial inheritance and potential for multiple paraganglioma. We believe the primary treatment of CBT should remain surgical resection, which can be performed with curative intent with minimal morbidity. Slow growth patterns in paragangliomas makes temporary or long‐term observation a treatment option in selected patients.