Surgical Management of Carotid Body Tumors: Experience of Two Centers

Abstract

Carotid body tumors (CBT) are rare but require surgical resection given their potential for growth and malignancy. For some surgical teams, tumor hypervascularity justifies preoperative embolization to facilitate resection and limit complications. The objective of our study was to evaluate two different practices of surgical resection with or without preoperative embolization in a two-center cohort. A consecutive series of patients who underwent CBT surgery, from January 2011 to June 2019, were divided into 2 groups, as to whether they were (ECBT) or not (NECBT) preoperatively embolized. Both groups were compared specifically according to the duration of operation, postoperative complications, and length of stay. Twenty-two patients with a mean age of 48.5 ± 14.3 years were included. In the series, 23 CBT were resected: 13 were embolized preoperatively; the mean time between embolization and surgery was 2.62 days ± 1.50. Both groups were comparable based on characteristics of population and tumor, with a mean size of 33.2 ± 11.9 mm. We noted a significant increase in operation duration in the ECBT group: 151 min (±40.9) vs 87.0 min (± 21) p<0.01. There was no difference between the 2 groups regarding cranial nerve (50% vs 46%; p=1), sympathetic nervous system (20% vs 23%; p=1), or vascular nerve (20% vs 23%; p=0.18) complications. No cerebrovascular accident was identified. The length of stay was 3.60 days (± 1.78) vs 3.73 days (± 1.19; p=0.44). This study reflects the experience of two centers in the management of CBT which is a rare pathology with no standardized treatment. Our series showed no significant difference between the ECBT and NECBT groups regarding postoperative complications and length of hospital stay. The reduction in operating time in the NECBT group remains to be demonstrated.