title: Diagnostic and Therapeutic Difficulties in Carotid Body Paragangliomas, Based on Clinical Experience and a Review of the Literature.
abstract: BACKGROUND
  Paragangliomas are rare neuroendocrine tumors, representing 0.03% of all tumors. Half of them develop in the head and neck, and among these 50% are sporadic cervical tumors.
  
  
  OBJECTIVE
  The aim of the study was to carry out an epidemiological and clinical analysis of paraganglioma patients diagnosed and treated at the authors' clinics between 1985 and 2014.
  
  
  METHODS
  The medical data of 47 patients were analyzed. All the patients were qualified for surgery. In 43 cases (88%), simple resection of the tumor was performed, including 11 cases (22%) that additionally required vascular suturing, and 5 (10%) that required reconstruction of the internal carotid artery. Carotid vessel repair was performed by shortening the internal carotid artery in 3 cases (6%), using a saphenous vein graft in 2 cases (4%), and by creating an anastomosis between the external carotid artery and the distal portion of the internal carotid artery in one case (2%).
  
  
  RESULTS
  In 40 cases (82%), the course of treatment was uneventful. Three patients (6%) were reoperated because of symptoms of cerebral stroke. Palsy of the hypoglossal nerve occurred in 3 cases (6%), and facial nerve palsy in 2 patients (4%). Six patients (12%) developed postoperative hematomas in the wound. In all the cases, histopathological examinations confirmed carotid paraganglioma.
  
  
  CONCLUSIONS
  Cooperation with an otolaryngologist and vascular surgeon during surgery is recommended due to frequent damage to carotid vessels by carotid paragangliomas. Detection of the tumor in the early stages improves surgical treatment outcomes and reduces the number of complications. Regular postoperative check-ups are necessary due to possible occurrences of multiple tumors.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Dorobisz
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland.|Department of Palliative Care and Oncology, Faculty of Health Science, Wroclaw Medical University, Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dorobisz
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Temporale
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Zatoński
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
authors.forename: Marzena
authors.initials: M
authors.lastname: Kubacka
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland.|Division of Surgical Specialties, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Chabowski
authors.affiliation: Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Dorobisz
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kręcicki
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland.|Division of Surgical Specialties, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
mesh_terms: D000328:Adult; D002345:Carotid Body Tumor / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000175:diagnosis* / Q000628:therapy*
keywords: carotid body paraganglioma; carotid body tumor; chemodectoma; diagnosis; surgical treatment