title: Surgical treatment of carotid body paragangliomas: outcomes and complications according to the shamblin classification.
abstract: OBJECTIVE
  The objective of this study was to review our experience in the surgical management of carotid body paragangliomas and evaluate the outcomes and complications according to the Shamblin classification.
  
  
  METHODS
  Thirteen patients who had been diagnosed and surgically treated for carotid body tumors (CBTs) were enrolled in this study. We reviewed patient demographics, radiographic findings, and surgical outcomes collected from medical records.
  
  
  RESULTS
  Fifteen CBTs were found in 13 patients and 13 tumors were resected. Selective preoperative tumor embolization was performed on six patients. The median blood loss, operation time, and hospital stay for these patients were not significantly reduced compared to those without embolization. The median tumor size was 2.3 cm in Shamblin I and II and 4 cm in Shamblin III. The median intraoperative blood loss was 280 mL and 700 mL, respectively (P<0.05). Internal carotid artery ligation with reconstruction was accomplished on three patients (23%), and they all belonged to Shamblin III (38%). One Shamblin III patient (8%) developed transient cerebral ischemia, and postoperative stroke with death occurred in another Shamblin III patient. Postoperative permanent cranial nerve deficit occurred in three patients (23%) who were all in Shamblin III (P=0.03). There were no recurrences or delayed complications at the median follow up of 29 months.
  
  
  CONCLUSIONS
  Shamblin III had a high risk of postoperative neurovascular complications. Therefore, early detection and prompt surgical resection of CBTs will decrease surgical morbidity.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Korea.
authors.forename: Jae-Yol
authors.initials: JY
authors.lastname: Lim
authors.forename: Jinna
authors.initials: J
authors.lastname: Kim
authors.forename: Sun Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Sak
authors.initials: S
authors.lastname: Lee
authors.forename: Young Chang
authors.initials: YC
authors.lastname: Lim
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Eun Chang
authors.initials: EC
authors.lastname: Choi