Perioperative strategies in the management of carotid body tumors

Despite the availability of noninvasive neuroradiographic techniques for the evaluation of head and neck neoplasms, paragangliomas of the carotid body often achieve substantial size before definitive diagnosis. Surgical “exploration” for the attempted resection of these lesions often results in sign...

Full description

Saved in:
Bibliographic Details
Published in:Otolaryngology-head and neck surgery 1997-07, Vol.117 (1), p.111-115
Main Authors: Leonetti, John P., Donzelli, Joseph J., Littooy, Fred N., Farrell, Brian P.
Format: Article
Language:English
Subjects:
Adult
Biopsy, Needle
Blood Loss, Surgical
Carotid Body Tumor - diagnosis
Carotid Body Tumor - surgery
Female
Humans
Intraoperative Care - methods
Magnetic Resonance Imaging
Male
Medical History Taking
Middle Aged
Physical Examination
Referral and Consultation
Retrospective Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Despite the availability of noninvasive neuroradiographic techniques for the evaluation of head and neck neoplasms, paragangliomas of the carotid body often achieve substantial size before definitive diagnosis. Surgical “exploration” for the attempted resection of these lesions often results in significant blood loss, inadvertent cranial nerve injury, and procedure abandonment with partial tumor removal. Sixteen carotid body tumors were surgically resected at our institution between July 1988 and January 1995. Four of these patients had undergone cytologic examination by fine-needle aspiration (FNA) and another 6 patients underwent failed attempted resection of their lesions as the result of intraoperative hemorrhage. Of the remaining 6 patients referred for the first time evaluation of a “neck mass,” the diagnosis was made by patient history, physical examination, magnetic resonance imaging, or magnetic resonance angiography. Complete tumor removal was accomplished in all 16 patients using a variety of lateral transcervical and skull base approaches. This article focuses on the clinicoradiographic diagnosis of carotid body tumors that do not need preoperative histologic confirmation. Specific intraoperative techniques for tumor removal, carotid artery management, and cranial nerve preservation are demonstrated through case presentations. Perioperative morbidity and overall results are detailed for this series of patients.
ISSN:0194-5998
1097-6817
DOI:10.1016/S0194-59989770216-X