Comparison of retrocarotid and caudocranial dissection techniques for the surgical treatment of carotid body tumors

Hinojosa, Carlos A.; Ortiz-López, Laura J.; Anaya‐Ayala, Javier E.; Orozco-Sevilla, Vicente; Núñez-Salgado, Ana E.

doi:10.1016/j.jvs.2015.05.001

Cited by 31 publications

(42 citation statements)

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“…7 Because of the high vascularity of these tumors and their complex anatomic location near cranial nerves and important blood vessels, resection can carry risks of blood loss and neurologic injuries. 6 The most experienced surgical centers worldwide have reported only 6 to 8 CBT resections annually, 8 so standardizing a technique is difficult. For decades, attempts to decrease the neurologic and vascular complications associated with surgery have included careful preoperative planning, the use of sensitive imaging methods, and adjunctive procedures such as embolization, stent-graft placement, and radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…For decades, attempts to decrease the neurologic and vascular complications associated with surgery have included careful preoperative planning, the use of sensitive imaging methods, and adjunctive procedures such as embolization, stent-graft placement, and radiotherapy. 8 Exposure to chronic hypoxia leads to enlargement of the carotid body from increasing glomus cell clusters and angiogenesis; this response can occur in patients with hypoxic cardiopulmonary diseases or in people who live at a high altitude, 6,9 such as in Mexico City. …”

Section: Discussionmentioning

confidence: 99%

“…We resected the CBT by using the retrocarotid dissection technique, gently rotating the ECA as previously described. 6 During the complication-free procedure, we resected the lymph nodes and sent them with the surgical specimen for pathologic analysis; the report confirmed malignancy. The patient recovered uneventfully and was discharged from the hospital in stable condition on postoperative day 2.…”

Section: Patientmentioning

confidence: 99%

“…6 Here, we describe our first 2 cases of malignant Shamblin III CBTs resected by means of retrocarotid dissection.…”

mentioning

confidence: 99%

“…5 We have reported our use of the retrocarotid dissection technique in the surgical treatment of benign CBTs, and the substantially shorter procedural times and hospital stays in comparison with using the standard caudocranial technique. 6 Here, we describe our first 2 cases of malignant Shamblin III CBTs resected by means of retrocarotid dissection.…”

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Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Hinojosa¹,

Anaya‐Ayala²,

Olivares-Cruz³

et al. 2018

Texas Heart Institute Journal

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A carotid body tumor (CBT) is a chemodectoma that most often originates from a gangliocytoma at the carotid bifurcation.1 These neoplasms were classified into 3 types by Shamblin and colleagues.2 A Shamblin I CBT is small and localized, a Shamblin II surrounds vessels or partially encloses them, and a Shamblin III is large and fully encloses adjacent vessels. Surgical resection, the appropriate treatment for CBT, 3 has typically been challenging because of the tumor's high vascularity, involvement of the carotid vessels, and proximity to the cranial nerves.4 In 6% to 12.5% of cases, CBTs have malignant potential and tend to grow and invade locally, causing symptoms. 5We have reported our use of the retrocarotid dissection technique in the surgical treatment of benign CBTs, and the substantially shorter procedural times and hospital stays in comparison with using the standard caudocranial technique. 6 Here, we describe our first 2 cases of malignant Shamblin III CBTs resected by means of retrocarotid dissection. Case Reports Patient 1A 17-year-old girl with no relevant medical history was referred to our institution in June 2014 with an expanding, painless, right-sided submandibular mass. She reported no pain, hoarseness, dyspnea, or dysphasia. A computed tomographic angiogram (CTA) showed a 5 × 3.7 × 6-cm hypervascular mass in the right carotid bifurcation (Fig. 1). Laboratory findings included elevated levels of plasma metanephrine (137 nmol/L; normal, <0.5 nmol/L) and normetaneprine (252 nmol/L; normal, <0.9 nmol/L). After we discussed treatment options with the patient and her parents, she underwent surgical resection.During surgery, the patient's head was turned toward her left. We then made a cervical incision centered over the carotid bifurcation, parallel and anterior to the sternocleidomastoid muscle, with extension to the mastoid region ( Fig. 2A). We extended the incision through the platysma muscle and down to the carotid sheath, and then pulled the jugular vein laterally. Proximal control of the common carotid artery was obtained just above the omohyoid muscle. Upon exposing the tendon of the digastric muscle, we identified the hypoglossal nerve and encircled it with a vessel loop. We ligated the common facial vein and performed subadventitial dissection of the mass

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patientmentioning

confidence: 99%

“…6 Here, we describe our first 2 cases of malignant Shamblin III CBTs resected by means of retrocarotid dissection.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Hinojosa¹,

Anaya‐Ayala²,

Olivares-Cruz³

et al. 2018

Texas Heart Institute Journal

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Current trends in carotid body tumors: Comprehensive review

et al. 2022

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Background: Carotid body tumor (CBT) is a rare neoplasm that has been increasingly studied during the last decades; nevertheless, it continues to be a topic of controversy. This review aims to provide an update on the general features of CBT and particularly review different treatment strategies and primary outcomes. Methods: Data for this literature review were identified by PubMed, Scopus, and Medline. 93 articles from the initial search were included, as well as 28 relevant studies utilizing the snowballing method; totaling 121 articles about CBT. Results: Main features such as anatomy, embryology, genetics, clinical presentation, and diagnosis of CBT are presented, followed by evidence of different treatment strategies such as radiotherapy, preoperative embolization, vascular resection, and vascular reconstruction. Main complications are also discussed. Conclusion:This review summarizes the most critical aspects regarding CBT. Future studies should compare different treatments to attain the best surgical results with lower morbidity rates.

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Resection of a Malignant Carotid Body Tumor with Carotid Artery Resection

Hans

2020

Challenging Arterial Reconstructions

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Comparison of retrocarotid and caudocranial dissection techniques for the surgical treatment of carotid body tumors

Abstract: The RCD technique is a safe and viable option for the surgical resection of CBTs. In our experience, this approach was associated with a significant decrease in procedural time and hospital stay.

Cited by 31 publications

References 32 publications

Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients

Current trends in carotid body tumors: Comprehensive review

Resection of a Malignant Carotid Body Tumor with Carotid Artery Resection

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