Moustafa Mourad1, Masoud Saman2, David Stroman2, Ryan Brown3, Yadranko Ducic4. 1. Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mt. Sinai, New York, New York, U.S.A. 2. Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A. 3. Department of Otolaryngology-Head and Neck Surgery, Kaiser-Permanente, Denver, Colorado, U.S.A. 4. Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A.. yducic@sbcglobal.net.
Abstract
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.
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.