Characteristics, surgical management, and outcome in 17 carotid body tumors

Tumors of the carotid body are relatively rare and may pose a difficult surgical problem because of their vascularity and compression of cranial nerves in the neck. This article reviews the physiology of the carotid body, its surgical history, and retrospectively reviews the management and outcome of 17 carotid body tumors occurring in 14 patients over an 18-year period at the University of Louisville Hospitals. The average age at presentation was 54.4 years. Three patients had bilateral tumors. Two patients (12%) had postoperative cranial nerve paralysis lasting greater than 6 months. One patient had a postoperative stroke after discharge from the hospital and subsequently died 2 months later from a pulmonary embolus. One patient had a malignant carotid body tumor and pulmonary metastasis and died 11 years after her original operation during an attempted embolization of recurrent carotid lesion. Early operation for the tumor is indicated to prevent nerve dysfunction due to compression and stretch injury as the lesion increases in size.