Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.727
Index Copernicus  – 166.39
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 6, November-December, p. 1173–1177

doi: 10.17219/acem/61612

Publication type: original article

Language: English

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Diagnostic and Therapeutic Difficulties in Carotid Body Paragangliomas, Based on Clinical Experience and a Review of the Literature

Karolina Dorobisz1,A,C, Tadeusz Dorobisz2,3,B,D, Hanna Temporale1,A,D, Tomasz Zatoński1,C,E, Marzena Kubacka1,B, Mariusz Chabowski2,4,C,D, Andrzej Dorobisz5,B,E, Tomasz Kręcicki1,D,F, Dariusz Janczak2,4,E,F

1 Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Poland

2 Department of Surgery, 4th Military Teaching Hospital, Wrocław, Poland

3 Department of Palliative Care and Oncology, Faculty of Health Science, Wroclaw Medical University, Poland

4 Division of Surgical Specialties, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Poland

5 Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Poland

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.
Objectives. 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.
Material and 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.
Conclusion. 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.

Key words

diagnosis, surgical treatment, chemodectoma, carotid body paraganglioma, carotid body tumor

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