+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

A meta-analysis on the surgical management of paraganglioma of the carotid body per Shamblin class

A meta-analysis on the surgical management of paraganglioma of the carotid body per Shamblin class

Clinical Otolaryngology 2018

The aim of this study was to evaluate the risk associated with different types of surgery for carotid body paraganglioma of different Shamblin class. A meta-analysis was conducted to evaluate per tumour class, the local control, cranial nerve damage and complication rates of different techniques using internal carotid artery (ICA) and external carotid artery (ECA) ligation, clamping or bypassing, as well as the craniocaudal vs caudocranial techniques. A meta-analysis is conducted after a systematic search in PubMed and the Cochrane library, in accordance with the PRISMA guidelines. Local control, cranial nerve damage, complications, function recovery. Out of 3565 articles, 27 were selected. The overall quality of evidence of studies was low. Cranial nerve damage (3%, 17% and 39%) and complication rates (0%, 1% and 10%) were significantly related to Shamblin class (class 1, 2 and 3, respectively, P < .01). For class 3 tumours, an increased risk of complications was found associated with routine ICA manipulation/reconstruction (RR 3.12 with a 95% CI of 1.29-7.59), as well as a trend towards enhanced risk of routine ECA ligation (RR 3.48 with a 95% CI of 0.88-13.81). For class 1 and 2 tumours, surgery seems a viable treatment option. For class 3 tumours, morbidity in terms of cranial nerve deficit and complications is considerable; particularly, the use of ICA manipulation/reconstruction and potentially ECA ligation seem to be accompanied by high stroke incidence.

(PDF emailed within 0-6 h: $19.90)

Accession: 046274439

Download citation: RISBibTeXText

PMID: 29656606

DOI: 10.1111/coa.13116

Related references

Surgical management of carotid body tumor - Is Shamblin classification sufficient to predict surgical outcome?. Vascular 25(2): 184-189, 2016

Concomitant Surgical Treatment of Symptomatic Carotid Artery Disease With a Coexisting Shamblin I Carotid Body Tumor. Vascular and Endovascular Surgery 51(2): 103-107, 2017

Does Shamblin's classification predict postoperative morbidity in carotid body tumors? A proposal to modify Shamblin's classification. European Archives of Oto-Rhino-Laryngology 263(2): 171-175, 2005

Surgical treatment of carotid body paragangliomas: outcomes and complications according to the shamblin classification. Clinical and Experimental Otorhinolaryngology 3(2): 91-95, 2010

Carotid body paraganglioma: review and surgical management. European Journal of Plastic Surgery 24(2): 58-65, 2001

A Systematic Review and Meta-Analysis of the Presentation and Surgical Management of Patients With Carotid Body Tumours. European Journal of Vascular and Endovascular Surgery 2019, 2019

The Effects of Preoperative Embolization on Carotid Body Paraganglioma Surgery: A Systematic Review and Meta-analysis. Otolaryngology--Head and Neck Surgery 153(6): 943-950, 2016

Paradigm Shift of Carotid Body Paraganglioma Surgical Technique from Caudocranial to Craniocaudal Dissection: Analysis of Recent Literature. International Journal of Head and Neck Surgery 5: 119-125, 2014

Radical resection of a Shamblin type III carotid body tumour without cerebro-neurological deficit: Improved technique with preoperative embolization and carotid stenting. International Journal of Oral and Maxillofacial Surgery 43(12): 1427-1430, 2015

Outcome of surgical treatment for carotid body paraganglioma. British Journal of Surgery 88(10): 1382-1386, 2001

Carotid body tumors: objective criteria to predict the Shamblin group on MR imaging. Ajnr. American Journal of Neuroradiology 29(7): 1349-1354, 2008

Coil embolization and surgical removal of carotid body paraganglioma. Journal of Craniofacial Surgery 24(3): E242-E245, 2014

Malignant Shamblin III Carotid Body Tumors Resected with Use of the Retrocarotid Dissection Technique in 2 Patients. Texas Heart Institute Journal 45(2): 92-95, 2018

Combined endovascular and surgical management of carotid paraganglioma. Angiologiia i Sosudistaia Khirurgiia 16(1): 65-69, 2010

Anesthetic management of a patient with NE-secreting carotid body paraganglioma. Masui. Japanese Journal of Anesthesiology 37(9): 1124-1129, 1988