Resection of Carotid Body Tumors in Patients of Advanced Age: Experience From a Single Center

Abstract

Introduction: Resection of carotid body tumor (CBT) in patients of advanced ages has not been appreciated. Objectives: This study aims to assess the clinical characteristics and perioperative comorbidities for CBT resection in patients of advanced age and to validate the application of an “isolated island” technique for extirpation of CBT. Methods: Eight patients of advanced age (≥60 years) who underwent CBT resection were enrolled as the study group (SG). Another 29 patients of younger age (<45 years old) underwent CBT extirpation were assigned as the control group (CG). The perioperative issues were compared between these 2 groups. Results: The “isolated island” technique was successfully applied for resection of CBT in all 37 patients. The prevalence of Shamblin classification I, II, and III tumors in the SG was 12.5%, 62.5%, and 25%; whereas in the CG was 10.3%, 55.2%, and 34.5%, respectively. Bilateral CBT was observed in 7 patients of the CG and none in the SG. Vascular reconstruction was required for 1 (12.5%) patient in the SG, while it was required for 8 (27.6%) patients in the CG. Postoperative vocal cord palsy occurred in 37.5% of patients in SG, whereas the vocal cord palsy (34.5%) and dysphagia (6.9%) were commonly encountered in CG. In addition to postoperative length of stay ( P = .004), no significant difference for operative time, intraoperative blood loss, or mortality were observed between these 2 groups ( P > .05). Conclusion: Extirpation of CBT in patients of advanced age is rationale in appropriately selected patients. The “isolated island” technique is safe for CBT resection with seemingly low complication rates.

Management of Multiple Head and Neck Paragangliomas With Assistance of a 3-D Model

“…Therefore, a bias may be present for usage of a 3-D model for establishment of a surgical plan. In addition, the decision to resect these multiple paragangliomas is determined by multiple factors, 26 critical multidisciplinary team discussion and the sufficient experience of the surgical team are prerequisites as part of the decision-making process for each case. 26…”

Paragangliomas of the head and neck: a contemporary review

“…Observation, therefore, may be indicated for small, benign, asymptomatic tumors, elderly patients, and/or those with surgical comorbidities ( Heesterman et al 2017 ). Nevertheless, for patients ≥60 years old and with minimal comorbidities, surgery remains a viable option at high-volume head and neck cancer centers, with outcomes comparable to patients of younger age ( Li et al 2021 ). The median time to growth is reportedly 1.5 years; surgery may therefore be delayed even in younger patients, if asymptomatic ( Heesterman et al 2017 ).…”

“…comorbidities, surgery remains a viable option at high-volume head and neck cancer centers, with outcomes comparable to patients of younger age(Li et al, 2021). The median time to growth is reportedly 1.5 years; surgery may therefore be delayed even in younger patients, if asymptomatic(Heesterman et al, 2017).…”