title: Neurological complications in carotid body tumors: a 6-year single-center experience.
abstract: OBJECTIVE
  Carotid body tumors are considered rare. However, there has been an increase in the number of these tumors managed at our center in recent years. Delayed presentation with large tumors is common. We studied the clinical profile, interventions, and outcomes of these tumors and assessed the factors influencing operative neurological morbidity and recurrence.
  
  
  METHODS
  This retrospective study was conducted at the Christian Medical College in Vellore, a tertiary care center in south India. We analyzed the inpatient and outpatient records of patients diagnosed to have carotid body tumors undergoing excision from January 1, 2005 to December 31, 2011. Patients diagnosed to have vagal paragangliomas were excluded.
  
  
  RESULTS
  Thirty-four of 48 tumors were excised from 32 patients (11 female, 21 male). Average age at presentation was 38.2 years, and three patients had familial bilateral tumors. All patients presented with a painless neck mass. There were 27 Shamblin group III, six Shamblin group II, and one Shamblin group I tumor. Eleven Shamblin group II/III tumors were associated with transient cranial nerve palsy or paresis (32.3%). Two Shamblin group III tumors were associated with perioperative stroke (5.8%). Preoperative embolization was done in 17 tumors, 12 of which were associated with neurological complications (two stroke, nine nerve palsy, one hemianopia). One patient underwent thrombolysis for a middle cerebral artery thrombus and recovered completely on follow-up, and another with a capsuloganglionic infarct managed conservatively had minimal persistent disability. Three patients had persistent nerve palsy (8.8%). Although complications were more common in patients with higher Shamblin group tumors, the difference was not statistically significant.
  
  
  CONCLUSIONS
  The overall rate of neurological complications is higher with tumors of higher Shamblin groups. Preoperative embolization was not effective in reducing neurological complications. The rates of postoperative stroke and permanent cranial nerve palsy after resection of large tumors are acceptable.
authors: Department of Vascular Surgery, Christian Medical College, Vellore, India. vascular@cmcvellore.ac.in
authors: Indrani
authors: I
authors: Sen
authors: Edwin
authors: E
authors: Stephen
authors: Karthik
authors: K
authors: Malepathi
authors: Sunil
authors: S
authors: Agarwal
authors: N K
authors: NK
authors: Shyamkumar
authors: Suraj
authors: S
authors: Mammen
mesh_terms: D000328:Adult; D002345:Carotid Body Tumor / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003389:Cranial Nerve Diseases / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D014656:Vascular Surgical Procedures / Q000009:adverse effects