Diagnosis, treatment and operative complications of carotid body tumours

Boer, F.; Terpstra, J. L.; M, Vink

doi:10.1002/bjs.1800680623

Cited by 43 publications

(8 citation statements)

References 11 publications

(10 reference statements)

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“…5,6,26 In our study, such injury rates were in the lower range, although we considered preoperative CN palsies, even if they were permanent, separately. Cranial nerve injury has been reported more often with advanced tumors, 43 carotid reconstruction, 4 and also glomus jugulare or vagal paragangliomas. 44 In our series, mandibular subluxation and ICA clamping were associated with an increased incidence of CN injury compared with those that did not require these maneuvers.…”

Section: Discussionmentioning

confidence: 99%

Contemporary presentation and evolution of management of neck paragangliomas

Kakkos

Reddy

Shepard

et al. 2009

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Contemporary presentation and evolution of management of neck paragangliomas

Kakkos

Reddy

Shepard

et al. 2009

Journal of Vascular Surgery

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“…14 In view of this relatively slow growth, selected patients may be better served with duplex surveillance, especially in light of the morbidity associated with surgical resection. Available reports 14,15 suggest that a smaller tumor size allows easier excision and a lower incidence of operative complications. Careful preoperative assessment by a multidisciplinary team, with attention to comorbidities and cranial nerve deficits, should be completed before therapeutic recommendations.…”

Section: Discussionmentioning

confidence: 99%

A Multidisciplinary Approach to Carotid Paragangliomas

Kasper¹,

Welling²,

Wladis

et al. 2007

Vasc Endovascular Surg

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The surgical management of carotid paragangliomas can be problematic. A multidisciplinary approach was used to include vascular surgery, otolaryngology, and neuroradiology to treat these patients over 9 years. From January 1992 to July 2001, a multidisciplinary team evaluated patients with carotid paragangliomas. Analyzed patient data included age, gender, diagnostic evaluation, tumor size, preoperative tumor embolization, operative exposure, need for extracranial arterial sacrifice/reconstruction, postoperative morbidity including cranial nerve dysfunction, and long-term follow-up. Twenty-five carotid paragangliomas in 20 patients underwent multidisciplinary evaluation and management. Average age was 51 years (range, 28-83 years), and 52% were male. Diagnostic evaluation included computed tomography in 76%, magnetic resonance imaging/magnetic resonance angiography in 52%, catheter angiography in 60%, and duplex ultrasonography in 16%. An extended neck exposure was required in 11 cases (44%), mandibulotomy was used once (4%), and mandibular subluxation was never required. The external carotid artery (ECA) was sacrificed in 8 cases (32%). The carotid bifurcation was resected in 1 patient (4%) requiring interposition reconstruction of the internal carotid artery. Preoperative tumor embolization was performed for 13 tumors (52%). Operative blood loss for patients undergoing preoperative embolization (Group I) was comparable to the nonembolized group (group II): group I lost 365 +/-180 mL versus 360 +/- 101 mL for group II (P = .48). This occurred despite larger tumors (group I - 4.2 cm versus group II - 2.1 cm, P = .03) and a higher mean Shamblin class (group I - 2.5 versus group II - 1.45, P = .001) for group I. There were no perioperative mortalities. Transient cranial nerve dysfunction occurred in 13 CBTs (52%), 2 (8%) of which remained present after 4 months. Patients with carotid paragangliomas benefit from a multidisciplinary team approach. Neuroradiology has been used for selective preoperative embolization, which has decreased estimated blood loss during excision of larger complex tumors. A combined surgical team of otolaryngology and vascular surgery provides for exposure of the distal internal carotid artery as high as the skull base, limited permanent cranial nerve dysfunction, and selective early division and excision of the external carotid artery for complete tumor resection.

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“…Many believe that surgical excision is the treatment of choice. 1,2,4, 8,12,14,15,27 Radiation therapy has not been commonly accepted as a cure for carotid body tumors, ',12 and its use may complicate later surgical intervention. Some believe that no intervention is necessary.…”

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confidence: 99%

Fine‐needle aspiration of six carotid body paragangliomas

Rodríguez

et al. 1993

Diagnostic Cytopathology

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We report six carotid body paragangliomas diagnosed by fine-needle aspiration (FNA) in five patients. A total of eight aspirations were performed. The cytologic findings are characteristic: hemorrhagic background, hypo- to hypercellular smears (depending on the skill of the aspirator) with cells having delicate, ill-defined, vacuolated cytoplasm, pleomorphic nuclei with distinct nucleoli, rare intranuclear cytoplasmic inclusions, and prominent rosette formation. No complications arose in any of the eight aspirations. FNA is a safe, accurate means of diagnosing carotid body paragangliomas. It can provide essential information for treatment planning and patient management.

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Diagnosis, treatment and operative complications of carotid body tumours

Cited by 43 publications

References 11 publications

Contemporary presentation and evolution of management of neck paragangliomas

Contemporary presentation and evolution of management of neck paragangliomas

A Multidisciplinary Approach to Carotid Paragangliomas

Fine‐needle aspiration of six carotid body paragangliomas

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