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Evaluating the role of embolization and carotid artery sacrifice and reconstruction in the management of carotid body tumors
Author(s) -
Mourad Moustafa,
Saman Masoud,
Stroman David,
Brown Ryan,
Ducic Yadranko
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26006
Subject(s) - medicine , neurovascular bundle , internal carotid artery , embolization , carotid body , surgery , internal jugular vein , external carotid artery , radiology , carotid arteries
Objectives/Hypothesis To review the surgical management of carotid body tumors (CBT), outcomes of carotid artery reconstruction, as well as utility of preoperative embolization. Study Design Retrospective chart review. Methods A single‐surgeon case series with chart review was performed of all cases between 1997 and 2014 at a single institution. Tumor classification, major neurovascular resection, requirement for in‐line carotid artery reconstruction, intraoperative blood loss, and operative time, and postoperative neurovascular complications were determined. Results In all, 96 patients with 101 CBTs underwent definitive resection disease. Vascular sacrifice was 2.9% (three) for the internal jugular vein, 8.9% (nine) for the external carotid artery, and 13.8% (14) for the internal carotid artery (ICA). ICA sacrifices were performed with immediate in‐line arterial bypass grafting with vascular surgery. Permanent cranial neuropathies occurred in 4.9% (five) of patients, without cerebrovascular events. Conclusions We recommend surgical resection as the primary approach to the management of these CBTs. In lesions involving the ICA, we recommend vein bypass grafting. We found no differences or advantages to preoperative embolization. Level of Evidence 4 Laryngoscope , 126:2282–2287, 2016