Does Shamblin classification affect the clinical outcomes following carotid body tumor excision?

Abstract

Objectives: In this study, we present the late results of patients who underwent carotid body tumor (CBT) resection and compared postoperative complication rates according to the Shamblin classification. Patients and methods: Between April 2012 and April 2019, a total of 55 consecutive patients (20 males, 35 females; mean age: 56.2±1.8 years; range, 38 to 62 years) who were operated for CBTs were retrospectively analyzed. The patients were classified according to the Shamblin classification. Demographic and clinical characteristics of the patients, postoperative complications, total amount of drainage, and length of hospital and intensive care unit stay were recorded. Results: Carotid body tumors were bilateral in five patients, while they involved only the right side in 23 and left side in 27 patients. The CBTs were Shamblin type 1 in 16, type 2 in 31, and type 3 in eight patients. Intraoperative vascular reconstruction was required in eight patients. Early postoperative morbidities were transient ischemic attack (TIA) in three, cranial involvement in nine, middle cerebral artery occlusion in one, dysphonia in six, dysphagia in six, and hemiparesthesia in one patient. Permanent neurological damage (hoarseness 10.9%, ptosis 45%, internal carotid artery 1.81%) was seen in 18.2% of the cases. The length of stay in the hospital and intensive care unit, total amount of drainage, rates of postoperative cranial nerve involvement, permanent neurological damage, disease recurrence, postoperative TIA, and dysphagia were found to be significantly increased in patients in the Shamblin type 3 (p<0.005). Conclusion: Surgery can be performed safely in Shamblin type 1 and 2 tumors, while surgery requires a more meticulous manipulation for type 3 tumors, as these tumors are associated with high cranial nerve damage and complication rates.