Introduction: This study aimed to evaluate outcomes in the surgical management of carotid body tumors (CBTs), assess long-term follow-up, and examine the importance of genetic testing for succinate dehydrogenase genes.
Materials and methods: We retrospectively reviewed 36 patients who had undergone resection of CBTs at our institution from 2013 to 2024. Data on patient history, symptoms, clinical features, diagnostic procedures, treatment modality, perioperative and late (persistent neurological disability and recurrence rate) complications, histological findings, DNA test, and secretory activity were analyzed.
Results: The average tumor size was 34.1 mm. A familial history of head and neck paragangliomas was present in 7 patients. According to the Shamblin classification, we observed 8/38 (21%) type III, 18/38 (47.4%) type II, and 12/38 (31.6) type I CBTs. Malignancy was present in two patients. No postoperative deaths or strokes occurred. Cranial nerve injury occurred in 8 patients (22.2%). Tumor size greater than 4 cm and Shamblin grade 3 were correlated with cranial nerve complications. The average follow-up period was 112.4 mo (range: 15-169 mo), including yearly clinical evaluations with Doppler carotid ultrasound. During this period, we observed 3 local recurrences and 1 new intrathoracic localization of paraganglioma.
Conclusions: Surgery is recommended for all patients with CBT and fit for open surgery. Early detection of small tumors may improve surgical outcomes and reduce complications.
Keywords: Carotid body tumors; Embolization; Paraganglioma; Radiation therapy; SDH mutation; Stereotactic radiosurgery; Surgery.
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