Multispecialty surgical management of carotid body tumors in the modern era

Mohebali, Jahan; Edwards, Heather; Schwartz, Samuel I.; Ergül, Emel; Deschler, Daniel G.; LaMuraglia, Glenn M.

doi:10.1016/j.jvs.2020.10.072

Cited by 15 publications

(22 citation statements)

References 18 publications

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“…76 Electroencephalographic (EEG) monitoring has also been used for recognizing cerebral ischemia, and it can also indicate the need for temporary intraluminal shunting. 64,77 The rate of vascular repair reported in the literature has ranged between 2.3% and 23.5%. 19,70,[78][79][80] The repair can be primary, autologous vein interposition graft (i.e., saphenous vein, femoral vein), prosthetic vascular interposition graft, patch angioplasty with bovine pericardium, or prosthetic graft.…”

Section: Vascular Resection and Reconstructionmentioning

confidence: 99%

“…CNI is the most frequent major complication. 77,79 Due to advances in surgery, the risk of cerebrovascular complications has been minimized; however, there have been no reported improvements in CNI. 92,94 Furthermore, CNI have been reported to occur at rates of up to 50%.…”

Section: Cranial Nerve Injurymentioning

confidence: 99%

“…Some authors used preoperative angiographic evaluation in tumors >4 cm 76 . Electroencephalographic (EEG) monitoring has also been used for recognizing cerebral ischemia, and it can also indicate the need for temporary intraluminal shunting 64,77 …”

Section: Treatmentmentioning

confidence: 99%

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Current trends in carotid body tumors: Comprehensive review

et al. 2022

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Background: Carotid body tumor (CBT) is a rare neoplasm that has been increasingly studied during the last decades; nevertheless, it continues to be a topic of controversy. This review aims to provide an update on the general features of CBT and particularly review different treatment strategies and primary outcomes. Methods: Data for this literature review were identified by PubMed, Scopus, and Medline. 93 articles from the initial search were included, as well as 28 relevant studies utilizing the snowballing method; totaling 121 articles about CBT. Results: Main features such as anatomy, embryology, genetics, clinical presentation, and diagnosis of CBT are presented, followed by evidence of different treatment strategies such as radiotherapy, preoperative embolization, vascular resection, and vascular reconstruction. Main complications are also discussed. Conclusion:This review summarizes the most critical aspects regarding CBT. Future studies should compare different treatments to attain the best surgical results with lower morbidity rates.

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Section: Vascular Resection and Reconstructionmentioning

confidence: 99%

Section: Cranial Nerve Injurymentioning

confidence: 99%

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Current trends in carotid body tumors: Comprehensive review

et al. 2022

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“…Surgical resection is a generally accepted treatment for CBTs (5). However, it has been reported that the incidence rate of permanent cranial nerve injury (p-CNI), including to the vagus nerve, hypoglossal nerve, sympathetic nerve, and glossopharyngeal nerve injury, after CBT resection is 3-20% (6)(7)(8). Hostile neck anatomy and insufficient preoperative preparation are thought to be the main causes of the high incidence of p-CNI (6).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have reported that a high incidence of nerve injury after CBT resection is consistently associated with higher Shamblin grade(18,19). However, Mohebali et al showed that postoperative nerve damage is not directly related to Shamblin classification(7).…”

mentioning

confidence: 97%

A new potential risk factor for permanent cranial nerve injury following carotid body tumor resection

Wen¹,

Zhou²,

Liu³

et al. 2023

Quant Imaging Med Surg

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Background: To quantify the association between the free distal segment length of the internal carotid artery (FDS-ICA) and permanent cranial nerve injury (p-CNI) following carotid body tumor (CBT) resection.Methods: This study is a case-control study. We surveyed 109 consecutive patients who underwent CBT resection between June 2015 and June 2020 at our single center. A total of 89 patients met the inclusion criteria and were selected for analysis. The FDS-ICA was measured by image post-processing software for computed tomography angiography (CTA). Postoperative p-CNI complications were evaluated using comprehensive statistical approaches. Results:The cohort was divided into 2 groups depending on the presence of p-CNI, namely the p-CNI group (n=17) and the non-CNI group (n=79). The average FDS-ICA of patients with p-CNI complications was shorter than that of those without p-CNI complications (P<0.001). For every 1 mm increase in FDS-ICA, there was an associated decrease of 8% in the risk of p-CNI (0.92, 95% CI: 0.85 to 0.98, P<0.05).Threshold effect analysis of the FDS-ICA on p-CNI identified that the FDS-ICA was 28.7 (95% CI: 23.8 to 30.9) mm. Conclusions:The results of this study revealed a significant independent association between FDS-ICA and permanent postoperative cranial nerve injury complications of CBTs. Further study is warranted to confirm these results in a larger patient cohort.

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Malignant carotid body tumors: What we know, what we do, and what we need to achieve. A systematic review of the literature

Piazza,

Lancini,

Tomasoni

et al. 2024

Head & Neck

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Malignant carotid body tumors (MCBT) are rare and diagnosed after detection of nodal or distant metastases. This systematic review (SR) focuses on MCBT initially approached by surgery. Preferred Reporting Items for SR and Meta‐Analysis (MA) guided the articles search from 2000 to 2023 on PubMed, Scopus, and Web of Science. Among 3548 papers, 132 (337 patients) were considered for SR; of these, 20 (158 patients) for MA. Malignancy rate was 7.3%, succinate dehydrogenase (SDH) mutation 17%, age at diagnosis between 4th and 6th decades, with a higher prevalence of females. MCBTs were mostly Shamblin III, with nodal and distant metastasis in 79.7% and 44.7%, respectively. Malignancy should be suspected if CBT >4 cm, Shamblin III, painful or otherwise symptomatic, at the extremes of age, bilateral, with multifocal disease, and SDHx mutations. Levels II–III clearance should be performed to exclude nodal metastases and adjuvant treatments considered on a case‐by‐case basis.

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Multispecialty surgical management of carotid body tumors in the modern era

Cited by 15 publications

References 18 publications

Current trends in carotid body tumors: Comprehensive review

Current trends in carotid body tumors: Comprehensive review

A new potential risk factor for permanent cranial nerve injury following carotid body tumor resection

Malignant carotid body tumors: What we know, what we do, and what we need to achieve. A systematic review of the literature

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