Neurovascular complications following carotid body paraganglioma resection

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• 作者：E. Lamblin^a ; ^b ; ^{ELamblin@chu-grenoble.fr" class="auth_mail" title="E-mail the corresponding author} ; I. Atallah^a ; ^b ; ^c ; E. Reyt^a ; ^b ; S. Schmerber^a ; ^b ; J.-L. Magne^b ; ^d ; C.A. Righini^a ; ^b ; ^c
• 关键词：Carotid body paraganglioma ; Surgery ; Neurovascular complications ; Shamblin classification
• 刊名：European Annals of Otorhinolaryngology, Head and Neck Diseases
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：133
• 期：5
• 页码：319-324
• 全文大小：718 K

文摘

The present consecutive case series reports our experience in the management of carotid body paraganglioma and aims to assess whether the Shamblin classification or tumor size are predictive of early and late postoperative neurovascular complications.

Material and methods

A retrospective study included 54 carotid body tumor resections in 49 patients, between 1980 and 2011. Data comprised early (< 1 month) and late (18 months) postoperative neurovascular complications.

Results

Early postoperative complications occurred in 31 cases, including 30 cases of cranial nerve deficit (56%). Cranial nerve deficit occurred in 83% of Shamblin III carotid body paragangliomas and was associated with significantly larger mean tumor size (4 ± 1.4 cm versus 2.9 ± 1.3 cm; P < 0.01). Shamblin III tumor and tumor size > 3.2 cm emerged as predictive factors for early postoperative peripheral neurological complications. Eight patients (17%) showed no cranial nerve deficit recovery, even after 18 months’ follow-up; no predictive factors could be identified for this.

Conclusion

Surgical resection remains the only curative treatment in carotid body paraganglioma, with low vascular morbidity. However, early postoperative nerve deficit remains frequent (56%), although mostly temporary, with 17% definitive sequelae at 18 months. Tumor size and Shamblin classification are predictive of early neurovascular complications.