Retroauricular approach for carotid body tumor resection: a case report

Carotid body tumors (CBTs) are rare and highly vascular paragangliomas arising at the carotid bifurcation. Surgical resection remains the standard treatment for CBTs. However, the conventional transcervical approach inevitably leaves a visible cervical scar, which may negatively affect quality of life in patients with cosmetic concerns.

A 27-year-old woman presented with a progressively enlarging right neck mass over a 6-month period. Ultrasonography demonstrated a hypervascular lesion surrounding the carotid arteries, and fine-needle aspiration was avoided because of the vascular nature of the tumor. Contrast-enhanced computed tomography revealed a 4-cm enhancing mass at the carotid bifurcation, highly suggestive of a CBT. Because the patient expressed concern regarding a visible cervical scar, a retroauricular approach was selected after thorough discussion of its potential risks and benefits. The operation was performed by a head and neck surgeon with intraoperative assistance from a vascular surgeon. Complete tumor resection was successfully achieved despite the need for repair of two small arterial defects encountered during tumor mobilization. The operative time was 300 minutes, and the estimated blood loss was 900 mL. The postoperative course was uneventful, and no major complications or tumor recurrence were observed during 12 months of follow-up. The patient reported satisfaction with the cosmetic outcome, although no objective cosmetic assessment was performed.

In carefully selected patients with Shamblin type I or II CBT, the retroauricular approach may represent a feasible hidden-scar alternative to the conventional transcervical approach.