Resection of Carotid Body Tumors and the Additional Choice of Intraoperative Shunt in Complicated Tumors

Background: The purpose of this article is to describe an additional choice of intraoperative shunt in the surgical repair of complicated carotid body tumors (CBTs). Methods: Between January 2005 and August 2010, 47 CBT resections were performed at our division. Thirty-seven patients underwent routine tumor resection (78.7%). However, 10 of the tumor resections were complicated because of severe adhesions and involvement of the carotid artery. It was difficult to excise the tumors using routine methods. Intraoperative shunts were used for resection of these 10 complicated tumors (21.3%). Results: All patients underwent successful resection of the CBTs. No severe intraoperative or postoperative complication was observed in the shunted group. There were two cases with hypotension and one case with blood pressure fluctuation in the unshunted group. The mean follow-up duration was 35.3 (range, 12-60) months. Conclusion: Surgical resection is the treatment of choice for CBTs. Shunts are not routinely used in the repair and represent just an additional choice for the resection of complicated CBTs. In this study, shunts have been shown to maintain cerebral circulation, decrease the size of tumor by excluding the vascular supply of the external carotid artery, and guide the resection when the tumors were complicated and difficult to excise. Shunt insertion was found to be safe and not associated with severe cerebrovascular complications.