Carotid body tumor surgery: Difference between revisions
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**For Shamblin type III cases with large tumors and malignant tumors involving important peripheral vessels resection and reconstructive vascular operation (including simple vascular anastomosis, internal carotid artery-common carotid artery artificial and autologous reconstructive vascular operation) is appropriate. | **For Shamblin type III cases with large tumors and malignant tumors involving important peripheral vessels resection and reconstructive vascular operation (including simple vascular anastomosis, internal carotid artery-common carotid artery artificial and autologous reconstructive vascular operation) is appropriate. | ||
==Indications== | |||
Surgery is indicated in:<ref name="pmid12886866">{{cite journal |vauthors=Hu K, Persky MS |title=Multidisciplinary management of paragangliomas of the head and neck, Part 1 |journal=Oncology (Williston Park, N.Y.) |volume=17 |issue=7 |pages=983–93 |date=July 2003 |pmid=12886866 |doi= |url=}}</ref> | |||
*Individuals with small to moderate-sized carotid body tumors and tympanic paragangliomas without cranial nerve dysfunction | |||
*Younger and middle-aged patients without coexisting medical problems | |||
*Individuals with a malignant tumor | |||
**Postoperative radiation therapy is also should be considered. | |||
==Contraindications== | ==Contraindications== | ||
Individuals who are poor candidates of surgery due to any reason.<ref>{{cite book | last = Eisele | first = David | title = Complications in head and neck surgery | publisher = Saunders | location = Edinburgh | year = 2008 | isbn = 978-1-4160-4220-4 }}</ref> | Individuals who are poor candidates of surgery due to any reason.<ref>{{cite book | last = Eisele | first = David | title = Complications in head and neck surgery | publisher = Saunders | location = Edinburgh | year = 2008 | isbn = 978-1-4160-4220-4 }}</ref> | ||
Revision as of 19:49, 10 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2]
Overview
Surgery is the mainstay of treatment for the carotid body tumor.
Surgery
Surgery is the treatment of choice for carotid body tumor.[1]
- Surgical approach of the tumor is different for each Shamblin subclassification:
- For Shamblin type I/II case without an abundant blood supply, simple resection of the tumor is the optimal treatment.
- For Shamblin type III cases with large tumors and malignant tumors involving important peripheral vessels resection and reconstructive vascular operation (including simple vascular anastomosis, internal carotid artery-common carotid artery artificial and autologous reconstructive vascular operation) is appropriate.
Indications
Surgery is indicated in:[2]
- Individuals with small to moderate-sized carotid body tumors and tympanic paragangliomas without cranial nerve dysfunction
- Younger and middle-aged patients without coexisting medical problems
- Individuals with a malignant tumor
- Postoperative radiation therapy is also should be considered.
Contraindications
Individuals who are poor candidates of surgery due to any reason.[3]
Complications of surgery
Surgical excision of the tumor may be complicated by:
- Cranial nerve involvement in 10% to 56% of the cases.
- The most commonly involved nerves are such as:
- The hypoglossal nerve
- The superior laryngeal nerve
- The vagus nerve,
- The mandibular branch of the facial nerve
- The pharyngeal branch of the vagus nerve
- The glossopharyngeal nerve
- The spinal accessory nerve
- The sympathetic chain
Radiotherapy
- Although previous literature claimed that radiotherapy is not effective for the treatment of the tumor, current studies have shown that the efficacy is comparable to those of the surgery.[1][2]
- Also, studies have shown that the complications of radiotherapy are lower in comparison with surgery.
Indications for radiotherapy
Radiotherapy is indicated in:[2]
- Elderly individuals
- High-risk patients with multiple or severe medical conditions
- Individuals with extensive skull-base or intracranial involvement
- Individuals with concurrent jugular or vagal paragangliomas and no evidence of lower cranial nerve dysfunction
- Individuals with multiple or bilateral tumors with the potential for severe postoperative debility from cranial nerve dysfunction
References
- ↑ 1.0 1.1 Luo T, Zhang C, Ning YC, Gu YQ, Li JX, Wang ZG (March 2013). "Surgical treatment of carotid body tumor: case report and literature review". J Geriatr Cardiol. 10 (1): 116–8. doi:10.3969/j.issn.1671-5411.2013.01.018. PMC 3627704. PMID 23610583.
- ↑ 2.0 2.1 2.2 Hu K, Persky MS (July 2003). "Multidisciplinary management of paragangliomas of the head and neck, Part 1". Oncology (Williston Park, N.Y.). 17 (7): 983–93. PMID 12886866.
- ↑ Eisele, David (2008). Complications in head and neck surgery. Edinburgh: Saunders. ISBN 978-1-4160-4220-4.