Carotid body tumor surgery: Difference between revisions
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**The sympathetic chain | **The sympathetic chain | ||
==Radiotherapy== | ==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.<ref name="pmid23610583">{{cite journal |vauthors=Luo T, Zhang C, Ning YC, Gu YQ, Li JX, Wang ZG |title=Surgical treatment of carotid body tumor: case report and literature review |journal=J Geriatr Cardiol |volume=10 |issue=1 |pages=116–8 |date=March 2013 |pmid=23610583 |pmc=3627704 |doi=10.3969/j.issn.1671-5411.2013.01.018 |url=}}</ref><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> | *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.<ref name="pmid23610583">{{cite journal |vauthors=Luo T, Zhang C, Ning YC, Gu YQ, Li JX, Wang ZG |title=Surgical treatment of carotid body tumor: case report and literature review |journal=J Geriatr Cardiol |volume=10 |issue=1 |pages=116–8 |date=March 2013 |pmid=23610583 |pmc=3627704 |doi=10.3969/j.issn.1671-5411.2013.01.018 |url=}}</ref><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><ref name="SuárezRodrigo2013">{{cite journal|last1=Suárez|first1=Carlos|last2=Rodrigo|first2=Juan P.|last3=Mendenhall|first3=William M.|last4=Hamoir|first4=Marc|last5=Silver|first5=Carl E.|last6=Grégoire|first6=Vincent|last7=Strojan|first7=Primož|last8=Neumann|first8=Hartmut P. H.|last9=Obholzer|first9=Rupert|last10=Offergeld|first10=Christian|last11=Langendijk|first11=Johannes A.|last12=Rinaldo|first12=Alessandra|last13=Ferlito|first13=Alfio|title=Carotid body paragangliomas: a systematic study on management with surgery and radiotherapy|journal=European Archives of Oto-Rhino-Laryngology|volume=271|issue=1|year=2013|pages=23–34|issn=0937-4477|doi=10.1007/s00405-013-2384-5}}</ref> | ||
*Also, studies have shown that the complications of radiotherapy are lower in comparison with surgery. | *Also, studies have shown that the complications of radiotherapy are lower in comparison with surgery. | ||
Revision as of 20:16, 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][4]
- 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.
- ↑ Suárez, Carlos; Rodrigo, Juan P.; Mendenhall, William M.; Hamoir, Marc; Silver, Carl E.; Grégoire, Vincent; Strojan, Primož; Neumann, Hartmut P. H.; Obholzer, Rupert; Offergeld, Christian; Langendijk, Johannes A.; Rinaldo, Alessandra; Ferlito, Alfio (2013). "Carotid body paragangliomas: a systematic study on management with surgery and radiotherapy". European Archives of Oto-Rhino-Laryngology. 271 (1): 23–34. doi:10.1007/s00405-013-2384-5. ISSN 0937-4477.