Meta-Analysis of the Effects of Preoperative Embolization on the Outcomes of Carotid Body Tumor Surgery

ABSTRACT Background Carotid body tumors (CBTs) are situated at the bifurcation of the common carotid artery within the adventitia, and are reported to be the most common head and neck paragangliomas. Surgery is the gold standard for curative treatment of resectable CBTs and is recommended in otherwise healthy patients because of the risk of local complications related to tumor size and a small but definite risk of malignancy. Preoperative embolization has been shown to reduce potential intraoperative blood loss and provide the surgeon with greater ease and safety in excising the tumor, thus reducing the operation time and morbidity. However, other physicians have stated that although blood loss may be reduced after preoperative embolization, transfusion requirements are not affected, and that the embolization procedure adds a significant risk for stroke. Therefore, the purpose of the current study was to compare the surgical outcomes of patients undergoing CBT surgical resection with and without preoperative embolization. Aim To evaluate the need for preoperative embolization for the treatment of carotid body tumor. Methodology A meta-analysis study is done to compare the surgical outcomes of patients undergoing CBT surgical resection with and without preoperative embolization. Results Our meta-analysis for evaluation of the effects of preoperative embolization on the outcomes of carotid body tumor surgery, included (14) studies with a total number of patients (n = 477).The results of these studies showed no statistically significant difference between preoperative embolization group and non embolization group in carotid body surgery for (blood loss & operation time). Preoperative embolization did not reduce risk of postoperative complications. Conclusion Preoperative embolization shows no statistically significant reducing in blood loss and operation time, also embolization does not decrease incidence of postoperative complications. It seems that embolization should not be a routine part of carotid body tumor surgery especially with the known potential risks and complications of this procedure .

Cascade of Complications Following Carotid Body Tumor Excision

Carotid body tumor excision can lead to various complications including vascular injury and pseudoaneurysm formation. Here we describe a case of carotid body tumor excision followed by series of complications including pseudoaneurysm formation, failure of primary surgical repair, carotid stump syndrome following parent artery occlusion, and persistent hypotension.