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Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-188X
Gupta A. K., Mathur N., Gupta A.
Department of Otorhinolaryngology, Head and Neck Surgery Post Graduate Institute of Medical Education and Research Chandigarh, India
Aim. Paragangliomas arise from extra adrenal paraganglionic tissues derived from the neural crest which has been recognized as a part of the amine precursor and uptake decarboxylase system. Diagnosis of the carotid body tumor is made clinically and confirmed with the help of radiology in the form of contrast CT and angiography.
Methods. A prospective study was conducted from July 1993 to June 2003 in the Department of Otolaryngology and Head and Neck Surgery, PGIMER, Chandigarh. Sixteen cases of carotid body tumor were admitted and treated surgically at this center. Surgical excision of the tumor was done in all cases by the transcervical approach without embolization. The age of the patients ranged from 21 to 56 years.
Results. Clinical examination showed a mass below the angle of the jaw which was laterally mobile. None of the patients had a positive family history in our series and all patients had urinary vanillyl mandelic acid within the normal range. All tumors had a homogeneously enhancing pattern with well defined margins. The angiographic pattern was highly vascular in all cases with supply mainly from small vessels from the external carotid artery.
Conclusion. The tumor can be safety resective in the subadventitial plane and angiography is the gold standard imaging technique. Intraoperative shunt is usually not required and intraoperative cerebral blood flow monitoring is an important adjunct to protect the cerebral hemisphere.