Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul

Background: Carotid body paraganglioma is a relatively rare neoplasm of obscure origin. They are usually benign and commonly present as asymptomatic cervical mass. The resection of carotid body tumors is difficult due to their being near to cranial nerves and arterial structures. We evaluated the surgical strategy and operative results of our patients. Methods: Between December 1985 and December 2006, nine patients (8 female, 1 males; mean age 54.22±8.94 years; range 38 to 65 years) with carotid body paraganglioma were operated. According to Shamblin classification, six tumors were type 2 and the other three were type 3. There was no sophisticated neurological complication preoperatively. The common symptom was a cervical mass in the neck. One patient had undergone surgical exploration to her neck. Results: The tumor was excised subadventitially in six patients, but the arterial structure was reconstructed in three patients with Shamblin type 3 paraganglioma using a polytetrafluoroethylene graft. The mean follow-up time was 41.66±45.36 months (range 2 to 138 months). There was no recurrence or permanent neurological complications in any of the patients. In one patient severe bleeding was observed. A patient with Y graft interposition had transient facial nerve paralysis without any late sequel. Conclusion: Surgical excision is the best treatment modality in patients with carotid body ganglioma. Arterial continuity should be maintained. In severe cases, special care has to be taken not to damage adjacent vascular and neural structures with careful dissection.