Neurovascular complications following carotid body paraganglioma resection.
OBJECTIVE
The present consecutive case series reports our experience in the management of carotid body paraganglioma and aims to assess whether the Shamblin classification or tumor size are predictive of early and late postoperative neurovascular complications.


METHODS
A retrospective study included 54 carotid body tumor resections in 49 patients, between 1980 and 2011. Data comprised early (<1month) and late (18 months) postoperative neurovascular complications.


RESULTS
Early postoperative complications occurred in 31 cases, including 30 cases of cranial nerve deficit (56%). Cranial nerve deficit occurred in 83% of Shamblin III carotid body paragangliomas and was associated with significantly larger mean tumor size (4±1.4cm versus 2.9±1.3cm; P<0.01). Shamblin III tumor and tumor size>3.2cm emerged as predictive factors for early postoperative peripheral neurological complications. Eight patients (17%) showed no cranial nerve deficit recovery, even after 18 months' follow-up; no predictive factors could be identified for this.


CONCLUSIONS
Surgical resection remains the only curative treatment in carotid body paraganglioma, with low vascular morbidity. However, early postoperative nerve deficit remains frequent (56%), although mostly temporary, with 17% definitive sequelae at 18 months. Tumor size and Shamblin classification are predictive of early neurovascular complications.
Unité d'oto-rhino-laryngologie et chirurgie cervico-faciale, centre hospitalo-universitaire de Grenoble, 1, avenue du Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France; Université Joseph-Fourier, Grenoble I, BP 53, 38041 Grenoble cedex 9, France. Electronic address: ELamblin@chu-grenoble.fr.
E
E
Lamblin
Unité d'oto-rhino-laryngologie et chirurgie cervico-faciale, centre hospitalo-universitaire de Grenoble, 1, avenue du Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France; Université Joseph-Fourier, Grenoble I, BP 53, 38041 Grenoble cedex 9, France; Inserm U823, institut Albert-Bonniot, BP 170, 38042 Grenoble cedex 9, France.
I
I
Atallah
Unité d'oto-rhino-laryngologie et chirurgie cervico-faciale, centre hospitalo-universitaire de Grenoble, 1, avenue du Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France; Université Joseph-Fourier, Grenoble I, BP 53, 38041 Grenoble cedex 9, France.
E
E
Reyt
Unité d'oto-rhino-laryngologie et chirurgie cervico-faciale, centre hospitalo-universitaire de Grenoble, 1, avenue du Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France; Université Joseph-Fourier, Grenoble I, BP 53, 38041 Grenoble cedex 9, France.
S
S
Schmerber
Université Joseph-Fourier, Grenoble I, BP 53, 38041 Grenoble cedex 9, France; Unité de chirurgie endocrinienne, thoracique et vasculaire, centre hospitalo-universitaire de Grenoble, 1, avenue du Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France.
J-L
JL
Magne
Unité d'oto-rhino-laryngologie et chirurgie cervico-faciale, centre hospitalo-universitaire de Grenoble, 1, avenue du Maquis-du-Grésivaudan, 38043 Grenoble cedex 9, France; Université Joseph-Fourier, Grenoble I, BP 53, 38041 Grenoble cedex 9, France; Inserm U823, institut Albert-Bonniot, BP 170, 38042 Grenoble cedex 9, France.
C A
CA
Righini
D000328:Adult; D002345:Carotid Body Tumor / Q000473:pathology / Q000601:surgery*; D003389:Cranial Nerve Diseases / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D011183:Postoperative Complications; D012189:Retrospective Studies
Carotid body paraganglioma; Neurovascular complications; Shamblin classification; Surgery