Impact Of Preoperative Embolization On Outcomes Of Carotid Body Tumor Resections

Objective:This study assessed neurovascular complications in the surgical management of carotid body tumors(CBTs),with emphasis on those treated with and without preoperative embolization.Methods: We reviewed the clinical data of all consecutive patients with CBTs treated by surgical resection in the first Affiliated Hospital of Fujian Medical University from June,2010 to June,2014. Outcomes were compared between all CBTs treated with preoperative embolization and with no preoperative embolization.Results: A total of 27 patients(16 women, 11 men), who were aged 42(range, 20-59) years, had resection of 27 CBTs. Tumors were unilateral in 22(left 12, right 10) and bilateral in 5. Familial cases occurred in 4 patients.There were 5 patients concurrent other paragangliomas(1 vagal paraganglioma, 3 glomus jugulares,1 liver paraganglioma). Average Maximum tumor diameter was 3.9(range, 1.5-6.4) cm. There were 17 cases in preoperative embolization group and 10 cases in nonpreoperative embolization group. Patient demographics, Shamblin class, and tumor diameter were similar in two groups. One patient occurred carotid artery dissection during the preoperative embolization procedure and a stent was implanted. There was no significant difference in operative time,temporary cranial nerve Injury, clinically apparent cranial nerve deficits between two groups.Conclusions: Large CBTs can be resected safely with or without preoperative embolization. Preoperative embolization may not simplify the conduct of the operation and does not reduce blood loss and decrease rates of cranial nerve injury.We should be meticulous to select the preoperative embolization in CBTs.