Surgical Management of Carotid Body Tumors at a High-Altitude Center: A 22-Year Single-Institution Experience

To evaluate surgical management and outcomes of carotid body tumors (CBTs) by Shamblin classification over 22 years at a center 1,853 m above sea level.

Among 107 patients who underwent surgery for 109 cervical masses suspected to be CBTs between 2000 and 2021, six patients with non-CBT histopathology were excluded. The final cohort comprised 101 patients with 103 confirmed CBTs, including two patients with bilateral disease. Tumor-level variables were reported for 103 tumors, whereas demographics and postoperative outcomes were reported once per patient. Continuous variables were compared using Student's t-test and categorical variables using Fisher's exact test.

The tumor-level distribution was Shamblin I in 12 tumors, Shamblin II in 79, and Shamblin III in 12. The mean age was 51.6 ± 13.3 years, and 81 patients (80.2%) were female. Complete resection was achieved in 99 patients; two Shamblin III tumors were partially resected. Fourteen patients required vascular reconstruction (nine Shamblin III, five Shamblin II). Preoperative embolization was used selectively in seven Shamblin III and six highly vascular Shamblin II tumors. Reexploration for hemorrhage occurred in four patients, temporary peripheral neurologic deficits in three, and central neurologic events in two. One in-hospital death occurred. Follow-up was available for 88 patients; no recurrence after complete resection or metastatic disease was documented, and both residual tumors remained stable.

Shamblin III tumors were associated with greater operative complexity and morbidity. Altitude may be a contributing context, but causality cannot be established. Embolization, NIRS, TTFM, and regional anesthesia remain practices requiring further evaluation.