Surgical treatment of carotid body tumor:Report of 14 consecutive cases

PURPOSE: To investigate preoperative preparation, surgical treatment and prevention of complications of carotid body tumor based on 14 consecutive cases between 1995 and 2003 at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai Second Medical University. METHODS: 13 of 14 patients with carotid body tumor underwent DSA (digital substrate angiography),among which 11 cases underwent TBO (temporary balloon occlusion) test and 1 patient underwent color Doppler inspection preoperatively. 14 cases were surgically treated with different kinds of procedures. 2 cases underwent simple peeling off of the tumors from the carotid artery; 3 cases underwent resection of both the tumor and the external carotid artery; 3 cases underwent resection of both the internal and external carotid artery and the tumor without carotid reconstruction; 3 cases underwent resection of the tumor and repair of the internal carotid artery; and 3 cases underwent resection of the internal, external carotid artery and the tumor with reconstruction of the internal carotid artery. In 1 case with malignant carotid body tumor and invasion of the cranial base, intra- and extra- cranial bypass was performed. RESULTS: All the patients were followed up for 1-9 years. No operative mortality was observed. One patient without carotid reconstruction couldn't calculate, another got hemiplegia one week after resection of the carotid body tumor and carotid artery. Both recovered within 6 months. No recurrence was found during the follow-up. CONCLUSION: Simple peeling off of the tumor from the carotid artery should be the treatment of choice for patients in the primary carotid body tumor surgery. For patients with malignant carotid body tumor or in the secondary operation, carotid reconstruction should be adopted to minimize intra and postoperative complications. Intra- and extra- cranial bypass is considered when necessary. Supported by Research Fund of the Ministry of Public Health (Grant No.96-1-340) and Sustentation Plan for Excellent Academic Leader of Shanghai Municipality (Grant No.96XD14013)