Clinical and Experimental Otorhinolaryngology Vol. 3, No. 2: 91-95, June 2010 DOI 10.3342/ceo.2010.3.2.91 Original Article Surgical Treatment of Carotid Body Paragangliomas: Outcomes and Complications According to the Shamblin Classification Jae-Yol Lim, MD1 Jinna Kim, MD2 Sun Ho Kim, MD3 Sak Lee, MD4 Jae Wook Kim, MD6 Eun Chang Choi, MD7 Young Chang Lim, MD5 1Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon; Departments of 2Radiology, 3Neurosurgery, 4Thoracic and Cardiovascular Surgery, Yonsei University Health System, Seoul; 5Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University College of Medicine, Seoul; 6Department of Otorhinolaryngology, Soonchunhyang University College of Medicine, Bucheon; 7Department of Otorhinolaryngology, Yonsei Head and Neck Cancer Clinic, Seoul, Korea Objectives. The objective of this study was to review our experience in the surgical management of carotid body para- gangliomas and evaluate the outcomes and complications according to the Shamblin classification. Methods. Thirteen patients who had been diagnosed and surgically treated for carotid body tumors (CBTs) were enrolled in this study. We reviewed patient demographics, radiographic findings, and surgical outcomes collected from med- ical records. Results. Fifteen CBTs were found in 13 patients and 13 tumors were resected. Selective preoperative tumor embolization was performed on six patients. The median blood loss, operation time, and hospital stay for these patients were not significantly reduced compared to those without embolization. The median tumor size was 2.3 cm in Shamblin I and II and 4 cm in Shamblin III. The median intraoperative blood loss was 280 mL and 700 mL, respectively (P<0.05). Internal carotid artery ligation with reconstruction was accomplished on three patients (23%), and they all belonged to Shamblin III (38%). One Shamblin III patient (8%) developed transient cerebral ischemia, and postoperative stroke with death occurred in another Shamblin III patient. Postoperative permanent cranial nerve deficit occurred in three patients (23%) who were all in Shamblin III (P=0.03). There were no recurrences or delayed complications at the median follow up of 29 months. Conclusion. Shamblin III had a high risk of postoperative neurovascular complications. Therefore, early detection and prompt surgical resection of CBTs will decrease surgical morbidity. Key Words. Carotid body tumor, Paraganglioma INTRODUCTION Carotid body tumors (CBTs) are slow-growing hypervascular tumors arising from paraganglionic cells of the carotid body which Received March 05, 2010 Accepted after revision May 18, 2010 Corresponding author : Eun Chang Choi, MD, PhD Department of Otorhinolaryngology, Yonsei Head and Neck Cancer Clinic, Yonsei University Health System, 250 Seongsan-no, Seodaemun-gu, Seoul 120-752, Korea Tel : +82-2-2228-3608, Fax : +82-2-393-0580 E-mail : eunchangmd@yuhs.ac acts as a vascular chemoreceptor organ and is usually located in the posteromedial wall of the CCA at the carotid bifurcation. CBTs are most commonly found among paragangliomas that are typi- cally located in four main sites in the head and neck: the carotid bifurcation (CBT), the foramen jugulare (jugular paraganglioma), the middle ear cavity (tympanic paraganglioma), and along the cervical portion of the vagus nerve (vagal paraganglioma) (1). Surgery is the gold standard for curative treatment of CBTs. The first successful CBT excision was performed by Albert in 1889 (2), and Gordon-Taylor (3) described a safe, subadventi- tial dissection in 1940. Since the 1980s, devascularization of Copyright 2010 by Korean Society of Otorhinolaryngology-Head and Neck Surgery. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 91