Surgical management of the carotid body tumors

Background: Carotid body tumors (CBT) arise from paraganglia tissue concentrated in the neck region. Chronic hypoxia and mutations in oxygen-sensing genes are responsible for etiopathogenesis of CBT and other paragangliomas. These uncommon tumors are usually benign but may occasionally produce local and distant metastasis. Surgical excision is the only curative treatment for these cervical paragangliomas.
Materials and Methods: The records of the patients undergoing surgery for CBT between January 1994 and January 2004 were analyzed. Eleven patients with a mean age of 32 years (range 21 to 48 years) were operated during this period. Patients were diagnosed by fine needle aspiration cytology, carotid angiography, color flow doppler ultrasonography and/or Magnetic Resonance angiography.
Results: Complete resection of the CBT was performed in all the patients. One patient had excessive bleeding due to a tear at common carotid artery bifurcation, which was successfully salvaged. There was one death due to intracerebral hemorrhage, secondary to accelerated hypertension. There were no postsurgical neurovascular sequelae in the other 10 patients.
Conclusion: Patients with CBT should be operated at an early stage of evolution. Improved imaging, vascular surgical techniques and understanding of the disease have vastly improved outcomes for these patients. CBT patients can be operated with low risk of morbidity and mortality.