The role of preoperative embolization in carotid body paraganglioma resection: A comparative outcome study

This study aimed to evaluate the efficacy of preoperative embolization (EMB) and its impact on complication rates in patients undergoing surgery for carotid body tumors (CBT) at a tertiary referral center.

A retrospective analysis was performed on 44 patients who underwent surgical resection of carotid body paragangliomas between January 2000 and June 2024. 13 patients with tumor size less than 3 cm, which is the recommended criterion for preoperative embolization, were excluded from the study. Patients who underwent preoperative embolization (EMB group) were retrospectively compared with patients who did not undergo preoperative embolization (NEMB group). The effects of embolization on cranial nerve injuries, internal carotid artery (ICA) repair, blood loss, operative time, transfusion requirements, and hospital stay duration were evaluated.

Preoperative EMB was not performed in 21 patients (67.7%), and EMB was performed in 10 patients (32.3%) with a CBT > 3 cm. No differences were observed between the two groups in terms of age, gender, tumor size, or Shamblin classification. Additionally, there was no significant difference regarding cranial nerve injury, ICA repair, external carotid artery ligation, or overall complications (p > 0.05). Hemoglobin decrease, operative time, and transfusion requirements were also comparable between the groups (p > 0.05). When the preoperative hospitalization period for embolization was excluded, the mean hospital stay was 4.19 ± 1.37 days in the NEMB group and 4.40 ± 2.46 days in the EMB group with no statistically significant difference (p = 0.761).

Preoperative EMB did not significantly alter overall complication rates in CBT surgery but may offer particular benefits for large tumors. Given the variability in tumor characteristics among patients, decisions regarding embolization should be individualized.