Radical resection of a Shamblin type III carotid body tumour without cerebro-neurological deficit: Improved technique with preoperative embolization and carotid stenting |
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| Affiliation: | 1. Oral and Maxillofacial–Head & Neck Oncology Department, Ninth People''s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Head and Neck Cancer Centre, Shanghai, China;2. Intervention Radiology Department, Ninth People''s Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Head and Neck Cancer Centre, Shanghai, China;1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Engineering of the Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;2. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China;1. Division of Oral and Maxillofacial Surgery, Section of Orofacial Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden;2. Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden;3. Division of Image and Functional Odontology, Section of Orofacial Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden;1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey;2. Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria;3. Orthopedics, Privat Hospital Maria Hilf, Klagenfurt, Austria;4. Department of Histology, Faculty of Medicine, Cukurova University, Adana, Turkey;1. Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;2. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan |
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| Abstract: | ![]()
The surgical resection of a large unfavourable Shamblin type III carotid body tumour (CBT) can be very challenging technically, with many potential significant complications. Preoperative embolization aids in shrinking the lesion, reducing intraoperative blood loss, and improving visualization of the surgical field. Preoperative internal carotid artery (ICA) stenting aids in reinforcing the arterial wall, thereby providing a better dissection plane. A woman presented to our institution with a large right-sided CBT. Failure of the preoperative temporary balloon occlusion (TBO) test emphasized the importance of intraoperative preservation of the ipsilateral ICA. A combination of both preoperative embolization and carotid stenting allowed a less hazardous radical resection of the CBT. An almost bloodless surgical field permitted meticulous dissection, hence reducing the risk of intraoperative vascular and nerve injury. Embolization and carotid stenting prior to surgical resection should be considered in cases with bilateral CBT or a skull base orientated high CBT, and for those with intracranial extension and patients who have failed the TBO test. |
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| Keywords: | head and neck cancer carotid body tumour embolization carotid stenting surgery |
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