Oral Presentation 5th International Symposium on Phaeochromocytoma and Paraganglioma 2017

Effective preoperative embolization of the feeding arteries just before carotid body tumor resection (#42)

Kiyoto Shiga 1 , Daisuke Saito 1 , Aya Ikeda 1 , Jun Miyaguchi 1 , Kodai Tuchida 1 , Shin-ichi Oikawa 1 , Katsunori Katagiri 1
  1. Iwate Medical University, Morioka, Japan

Carotid body tumor (CBT) is a rare tumor derived from carotid body paraganglion cells. It is well known that this tumor has a rich vascular network in its contents and capsules supplied by many feeding arteries. When Head and Neck Surgeons intend to resect this tumor, they sometimes experience much blood loss or injuries of carotid arteries’ wall. In some cases reconstruction surgeries are required to repair or replace the damage of carotid arteries. To save blood loss during surgery of CBT, preoperative embolization of the feeding arteries is sometimes carried out. However, this procedure has been controversial about its effectiveness for the surgery so far.  We planned to try embolization of the feeding arteries just before surgery and performed the surgery at the same day.

From March 2013 to September 2016, 11 patients with CBT were referred to our hospital for the radical resection of the tumor. They were 8 female and 3 male patients and their mean age was 45.4 years old ranging from 23 to 62 years old. Three patients had family history of paragangliomas. The patients underwent embolization of the feeding arteries under local anesthesia in the morning. They underwent resection of the tumor under general anesthesia just after the embolization of the feeding arteries in the afternoon of the day. The average time of surgery was 109 min. and the average blood loss was 10.5 ml. Complications of surgery in our series of patients were first bite syndrome in 3 patients, recurrent nerve palsy in 2, glossopharyngeal nerve palsy in 1, hypoglossal nerve palsy in 1 and Horner syndrome in 1.

Our “ one-day procedure” resulted in obvious reduction of blood loss and operation time. We concluded that this method is superior to other procedures for the safety of CBT surgery.