Surgical diagnosis and treatment of carotid body tumor: a report of 27 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Jianqiang , LI Chengjin , ZHANG Zaizhong , WANG Lie ,  CHEN Jianwei

Department of General Surgery, Fuzhou General Hospital of The Chinese People’s Liberation Army, Fuzhou 350025, P. R. China;

Corresponding author：

CHEN Jianwei, Email: myself008@126.com

Keywords：

carotid body tumor; diagnosis; treatment; complication

DOI：

10.7507/1007-9424.201707091

Video：

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Objective To sum up the diagnosis, treatment, and prevention of postoperative complications of carotid body tumor. Methods The clinical data of 27 patients (30 aneurysms) with carotid body tumor who treated in our hospital from June 2005 to June 2016 were analyzed retrospectively. Results Of the 27 patients, 24 patients had unilateral lesions and 3 patients had bilateral lesions, with a total of 30 aneurysms. Three patients received color Doppler ultrasound, 18 patients received computed tomography angiography, 3 patients received magnetic resonance angiography, and 6 patients received digital subtraction angiography. According to Shamblin classification: 10 aneurysms belonged to typeⅠ, 16 aneurysms belonged to typeⅡ, 4 aneurysms belonged to type Ⅲ. Twenty aneurysms were treated with simple stripping, 6 aneurysms were treated with tumor resection and external carotid artery resection, 2 aneurysms were resected by resection, partial carotid artery resection plus external-internal carotid artery anastomosis, 2 aneurysms were resected by resection, resection of internal carotid artery, external carotid artery, and common carotid artery, as well as internal carotid artery-common carotid artery bypass. All patients underwent a successful operation with no death. After surgery,1 patient suffered from hemiplegia, 2 patients suffered from hoarseness, and 1 patient suffered from cough. Of the 27 patients, 24 patients were followed-up from 3 months to 4 years, with a median time of 2.3 years. During the follow-up procedure, the 1 patient with hemiplegic recovered to more than three levels of muscle strength after 6 months after rehabilitation, the 2 patients with hoarseness and 1 patient with cough returned to normal after 2 months after symptomatic treatment. There was no recurrence during follow-up procedure, and no other complications occurred. Conclusion Computed tomography angiography and magnetic resonance angiography are propitious to the definitive diagnosis of carotid body tumor, and actively surgical treatment should be performed once diagnosis of carotid body tumor.

Citation： HUANG Jianqiang, LI Chengjin, ZHANG Zaizhong, WANG Lie, CHEN Jianwei. Surgical diagnosis and treatment of carotid body tumor: a report of 27 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(1): 48-53. doi: 10.7507/1007-9424.201707091 Copy

1.	李冬林, 赵渝. 颈动脉体瘤的外科治疗. 中国血管外科杂志(电子版), 2013, 5(2): 94-96.
2.	Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
3.	Unlü Y, Becit N, Ceviz M, et al. Management of carotid body tumors and familial paragangliomas: review of 30 years’ experience. Ann Vasc Surg, 2009, 23(5): 616-620.
4.	Shamblin WR, ReMine WH, Sheps SG, et al. Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg, 1971, 122(6): 732-739.
5.	Nishijima H, Asakage T, Sugasawa M. Malignant carotid body tumor with systemic metastases. Ann Otol Rhinol Laryngol, 2011, 120(6): 381-385.
6.	黄志刚, 郭伟, 寇秀娟, 等. 颈动脉体瘤家系琥珀酸脱氢酶 D 亚单位基因截短体 R38X 质粒构建和体外功能验证. 中国耳鼻咽喉头颈外科, 2014, 21(2): 57-60.
7.	Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
8.	Lian LS, Liu CW, Guan H, et al. Efficacy of surgical therapy for carotid body tumors. Chin Med Sci J, 2011, 26(4): 241-245.
9.	刘翠, 许春伟, 王晶晶, 等. 颈动脉体瘤临床病理分析并文献复习. 解放军医药杂志, 2015, 27(2): 103-106.
10.	戈小虎. 颈动脉体瘤的诊疗进展. 国际外科学杂志, 2013, 40(12): 793-796.
11.	佘志强, 刘继远. 颈动脉体瘤的诊治进展. 国际耳鼻咽喉头颈外科杂志, 2016, 40(3): 168-172.
12.	陈晓红, 房居高, 张洋, 等. ShamblinⅢ型颈动脉体瘤手术治疗. 中国耳鼻咽喉头颈外科, 2012, 19(6): 289-292.
13.	胡敏, 张立海, 杨舸, 等. 选择性血管栓塞术辅助颈动脉体瘤切除术. 华西口腔医学杂志, 2010, 28(4): 387-390.
14.	Patlola R, Ingraldi A, Walker C, et al. Carotid body tumor. Int J Cardiol, 2010, 143(1): e7-e10.
15.	Gemmete JJ, Pandey AS, Chaudhary N, et al. Paradoxical embolus to the brain from embolization of a carotid body tumor. J Neurointerv Surg, 2012, 4(4): e12.
16.	Demir T, Uyar I, Demir HB, et al. Five-year follow-up of a patient with bilateral carotid body tumors after unilateral surgical resection. Am J Case Rep, 2014, 15: 426-430.
17.	唐军, 张磊, 李继军, 等. 头颈部富血供肿瘤的术前栓塞治疗. 中华介入放射学电子杂志, 2014, 2(1): 5-7.
18.	Power AH, Bower TC, Kasperbauer J, et al. Impact of preoperative embolization on outcomes of carotid body tumor resections. J Vasc Surg, 2012, 56(4): 979-989.
19.	Bercin S, Muderris T, Sevil E, et al. Efficiency of preoperative embolization of carotid body tumor. Auris Nasus Larynx, 2015, 42(3): 226-230.
20.	戚悠飞, 肖占祥, 曾昭凡, 等. 颈动脉体瘤的诊断与外科治疗. 临床外科杂志, 2012, 20(8): 554-556.
21.	叶茂昌, 王来平, 李容新, 等. 超声刀在颈淋巴清扫术中的临床应用. 口腔颌面外科杂志, 2014, 24(1): 35-38.
22.	冯亚茹, 陈晓红, 寇秀娟, 等. 双侧颈动脉体瘤的个体化治疗. 中华耳鼻咽喉头颈外科杂志, 2017, 52(1): 37-43.
23.	Sen I, Stephen E, Malepathi K, et al. Neurological complications in carotid body tumors: a 6-year single-center experience. J Vasc Surg, 2013, 57(2 Suppl): 64S-68S.
24.	蒋京军, 张学民, 李伟, 等. 双侧颈动脉体瘤的手术治疗. 中华普通外科杂志, 2015, 30(1): 35-37.
25.	李武, 田皞, 喻建军, 等. 双颈动脉体瘤术后压力感受器衰竭综合征一例. 中华耳鼻咽喉头颈外科杂志, 2014, 49(9): 779-780.
26.	Ghali MGZ, Srinivasan VM, Hanna E, et al. Overt and Subclinical Baroreflex Dysfunction After Bilateral Carotid Body Tumor Resection: Pathophysiology, Diagnosis, and Implications for Management. World Neurosurg, 2017, 101: 559-567.

1. 李冬林, 赵渝. 颈动脉体瘤的外科治疗. 中国血管外科杂志(电子版), 2013, 5(2): 94-96.
2. Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
3. Unlü Y, Becit N, Ceviz M, et al. Management of carotid body tumors and familial paragangliomas: review of 30 years’ experience. Ann Vasc Surg, 2009, 23(5): 616-620.
4. Shamblin WR, ReMine WH, Sheps SG, et al. Carotid body tumor (chemodectoma). Clinicopathologic analysis of ninety cases. Am J Surg, 1971, 122(6): 732-739.
5. Nishijima H, Asakage T, Sugasawa M. Malignant carotid body tumor with systemic metastases. Ann Otol Rhinol Laryngol, 2011, 120(6): 381-385.
6. 黄志刚, 郭伟, 寇秀娟, 等. 颈动脉体瘤家系琥珀酸脱氢酶 D 亚单位基因截短体 R38X 质粒构建和体外功能验证. 中国耳鼻咽喉头颈外科, 2014, 21(2): 57-60.
7. Wieneke JA, Smith A. Paraganglioma: carotid body tumor. Head Neck Pathol, 2009, 3(4): 303-306.
8. Lian LS, Liu CW, Guan H, et al. Efficacy of surgical therapy for carotid body tumors. Chin Med Sci J, 2011, 26(4): 241-245.
9. 刘翠, 许春伟, 王晶晶, 等. 颈动脉体瘤临床病理分析并文献复习. 解放军医药杂志, 2015, 27(2): 103-106.
10. 戈小虎. 颈动脉体瘤的诊疗进展. 国际外科学杂志, 2013, 40(12): 793-796.
11. 佘志强, 刘继远. 颈动脉体瘤的诊治进展. 国际耳鼻咽喉头颈外科杂志, 2016, 40(3): 168-172.
12. 陈晓红, 房居高, 张洋, 等. ShamblinⅢ型颈动脉体瘤手术治疗. 中国耳鼻咽喉头颈外科, 2012, 19(6): 289-292.
13. 胡敏, 张立海, 杨舸, 等. 选择性血管栓塞术辅助颈动脉体瘤切除术. 华西口腔医学杂志, 2010, 28(4): 387-390.
14. Patlola R, Ingraldi A, Walker C, et al. Carotid body tumor. Int J Cardiol, 2010, 143(1): e7-e10.
15. Gemmete JJ, Pandey AS, Chaudhary N, et al. Paradoxical embolus to the brain from embolization of a carotid body tumor. J Neurointerv Surg, 2012, 4(4): e12.
16. Demir T, Uyar I, Demir HB, et al. Five-year follow-up of a patient with bilateral carotid body tumors after unilateral surgical resection. Am J Case Rep, 2014, 15: 426-430.
17. 唐军, 张磊, 李继军, 等. 头颈部富血供肿瘤的术前栓塞治疗. 中华介入放射学电子杂志, 2014, 2(1): 5-7.
18. Power AH, Bower TC, Kasperbauer J, et al. Impact of preoperative embolization on outcomes of carotid body tumor resections. J Vasc Surg, 2012, 56(4): 979-989.
19. Bercin S, Muderris T, Sevil E, et al. Efficiency of preoperative embolization of carotid body tumor. Auris Nasus Larynx, 2015, 42(3): 226-230.
20. 戚悠飞, 肖占祥, 曾昭凡, 等. 颈动脉体瘤的诊断与外科治疗. 临床外科杂志, 2012, 20(8): 554-556.
21. 叶茂昌, 王来平, 李容新, 等. 超声刀在颈淋巴清扫术中的临床应用. 口腔颌面外科杂志, 2014, 24(1): 35-38.
22. 冯亚茹, 陈晓红, 寇秀娟, 等. 双侧颈动脉体瘤的个体化治疗. 中华耳鼻咽喉头颈外科杂志, 2017, 52(1): 37-43.
23. Sen I, Stephen E, Malepathi K, et al. Neurological complications in carotid body tumors: a 6-year single-center experience. J Vasc Surg, 2013, 57(2 Suppl): 64S-68S.
24. 蒋京军, 张学民, 李伟, 等. 双侧颈动脉体瘤的手术治疗. 中华普通外科杂志, 2015, 30(1): 35-37.
25. 李武, 田皞, 喻建军, 等. 双颈动脉体瘤术后压力感受器衰竭综合征一例. 中华耳鼻咽喉头颈外科杂志, 2014, 49(9): 779-780.
26. Ghali MGZ, Srinivasan VM, Hanna E, et al. Overt and Subclinical Baroreflex Dysfunction After Bilateral Carotid Body Tumor Resection: Pathophysiology, Diagnosis, and Implications for Management. World Neurosurg, 2017, 101: 559-567.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical diagnosis and treatment of carotid body tumor: a report of 27 cases

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