颈动脉体瘤的外科治疗

目的：探讨颈动脉体瘤（CBT）的外科治疗方法，方法：回顾性分析78例CBT的临床资料。结果：78例共88个肿瘤（双侧CBT10例）中切除83个，手术方式：CBT剥除28例侧；CBT与颈外动脉同时切除12例侧；CBT剥离式切除和颈内动脉部分切除，颈内动脉间置吻合3例侧，颈内动脉对端吻合1例侧，颈外动脉与颈内动脉吻合1例侧；CBT与颈总动脉整块切除颈动脉重建30例侧；CBT切除与颈总动脉结扎8例侧；手术死亡率为3．8％（3／78），65例术后随访1－21年，64例仍存活，1例于术后7年死于肺转移。随访期间，1例术后2年局部复发，行再次切除已8年无复发；1例家族性病例左侧病变切除后10年出现右侧病变。结论：颈动脉体瘤可双侧发病，可有家族性，可恶变和可有内分泌相关的特性，对于较小的瘤体术中常可用分离法加以切除；涉及颈外动脉时可将其与瘤体同时切除；涉及颈内动脉而瘤体难以完全自颈内动脉剥脱时，可切除部分颈内动脉，行对端吻合，人工血管间置移植或以颈外动脉与之吻合，瘤体过大或粘连严重时，对端吻合可在瘤体横断面的颈内动脉上进行。     

双侧颈动脉体瘤的手术治疗

目的 探讨双侧颈动脉体瘤的手术治疗.方法 回顾性分析北京大学人民医院1994年以来收治的5例双侧颈动脉体瘤患者的临床资料.男1例,女4例,2例女性为姐妹,年龄26～48岁,平均(37±10)岁.5例患者均表现为双侧颈部无痛性肿物,术前行喉镜检查了解声带活动情况,双侧肿瘤均分次切除,先切除肿瘤体积较小一侧.2例Shamblin Ⅰ型和2例ShamblinⅡ型行单纯肿瘤切除;3例ShamblinⅡ型行肿瘤加颈外动脉切除;3例ShamblinⅢ型切除肿瘤并行颈内动脉重建,2例应用自体大隐静脉,1例应用直径6 mm人工血管,动脉重建过程中使用转流管保持颈内动脉血供.结果 5例患者双侧肿瘤均完整切除,病理证实为良性颈动脉体瘤,无肿瘤残留者,未发生脑缺血并发症,未出现颈部血肿,未出现压力感受器调节失效综合征,2例术后出现颅神经损伤.随访时间6～39个月,平均(25±13)个月,未发现肿瘤复发和转移,3例颈内动脉重建者未发现颈动脉血栓形成.结论 双侧颈动脉体瘤分次手术切除是安全的,颈动脉转流管有助于术中肿瘤切除.     

颈动脉体瘤的临床诊治

目的探讨颈动脉体瘤(CBT)的诊断、治疗方式及术后并发症。方法回顾性分析2016年4月至2016年9月我科收治的5例颈部肿物患者的临床资料。根据Shamblin分型标准:Ⅰ型1例,Ⅱ型2例,Ⅲ型2例。1例ShamblinⅠ型及2例ShamblinⅡ型患者行单纯肿物剥离术,1例ShamblinⅢ型患者行肿物切除+血管重建术,1例ShamblinⅢ型患者行血管内介入栓塞术。结果 1例ShamblinⅠ型患者术后病理确诊为神经鞘瘤,余患者病理均为副神经节瘤。1例ShamblinⅢ型患者行血管内介入栓塞术后出现偏瘫,余4例手术患者均完整切除肿瘤,无死亡、偏瘫及神经功能障碍。结论影像学检查是诊断CBT的最佳方法,手术切除是其首选治疗方式,通过完整、有效的术前评估和选择合理的治疗方案可以有效预防和减少术后并发症的发生。     

颈动脉体瘤诊治的临床分析：附38例报告

目的：总结颈动脉体瘤（CBT）的临床特征与诊治经验。 方法：回顾性分析2008年10月—2019年4月在中南大学湘雅医院血管外科治疗的38例CBT患者资料,其中男14例,女24例;年龄23~76岁;单侧36例,双侧2例;40个瘤体中,Shamblin I型6个、II型12个、III型22个。 结果：所有患者均行颈部CTA或MRA明确诊断。38例患者中,3例单侧患者行保守治疗,其余35例患者共37个瘤体行手术切除治疗,其中1例手术患者术前行DSA检查并行双侧颈外动脉栓塞术。无术中死亡病例,手术平均时间（140±48）min,术中平均出血量（194±148）mL;Shamblin I型病变均行单纯CBT切除,Shamblin II、III型病变行单纯CBT切除或CBT切除+其他手术（颈部动脉离断、重建、结扎）。所有手术患者术后病理检查均证实为颈部良性副神经节瘤。术后发生短暂脑神经损伤8例,永久脑神经损伤2例,死亡1例。单纯CBT切除患者的神经损伤发生率明显低于CBT切除联合其他手术患者（P<0.05）。随访半月至10年,手术患者未出现肿瘤复发及其他并发症。3例保守治疗患者均带瘤生存。 结论：CTA或MRA为诊断CBT的首选方法,手术切除是CBT的首选治疗方法。手术方式的选择还需根据瘤体的大小形态以及分型决定。     

133例颈动脉体瘤手术危险因素分析北大核心CSCD

目的总结颈动脉体瘤外科手术经验,分析手术风险相关危险因素。方法回顾性分析解放军总医院第一医学中心血管外科2005年11月至2019年4月完成手术的133例颈动脉体瘤患者的临床和随访资料。结果 142侧瘤体均成功实施手术切除,围手术期及术后30 d内无患者死亡。单纯瘤体切除33侧(23.2%),瘤体切除联合颈外动脉断扎82侧(57.8%),颈内动脉重建13侧(9.2%),颈总或颈外动脉修补10例(7.0%),颈总或颈内动脉结扎4侧(2.8%)。手术并发症53例,其中颅神经损伤43例。平均手术时间161 min(60~500 min),平均出血量308 ml(20~3 000 ml)。随访时间1~162个月,随访期间无死亡病例。结论颈动脉体瘤大小及Shamblin分型是影响手术风险的相关危险因素。ShamblinⅠ型多可单纯瘤体切除,Ⅱ型、Ⅲ型往往需要断扎颈外动脉甚至重建颈内动脉,大隐静脉重建具有较好的远期通畅率。     

术中颈内动脉转流在颈动脉体瘤切除中的应用

目的 总结颈动脉体瘤(carotid body tumor,CBT)的临床特点,诊断和外科治疗体会,以及术中颈内动脉转流在切除复杂颈动脉体瘤中的应用及效果.方法 回顾性分析1991年1月至2008年12月30例颈动脉体瘤的外科治疗,其中4例患者采用术中颈内动脉转流的临床资料.患者平均年龄(39.2±2.3)岁,男10例,女20例.左侧15例,右侧14例,双侧1例,平均直径(4.9±0.3)cm.术前经彩超、CT、MRI、CTA等明确诊断.手术方式采用单纯颈动脉体瘤切除16例,颈动脉体瘤切除加颈外动脉结扎10例,颈动脉体瘤切除加术中颈内动脉转流自体大隐静脉血管重建4例.结果 30例手术顺利成功,术后经病理检查结果证实均为颈动脉体瘤,4例患者存在血管壁包膜侵犯.术后并发症:声嘶15例,呛咳11例,舌歪17例,面部麻木2例,呼吸困难1例,吞咽困难3例.4例术中行颈内动脉转流下顺利切除瘤体,术后无脑梗塞.全部病例术后无死亡.结论 颈动脉体瘤首选的治疗方式是外科切除.复杂Shamblin Ⅲ型CBT术中必要时采用颈内动脉转流下切除瘤体是一种安全,有效的治疗手段.     

颈动脉体瘤的无术前栓塞手术切除的疗效分析：附单中心65例报告

背景与目的：颈动脉体瘤（CBT）是临床上非常罕见的疾病,目前外科手术是治疗CBT的金标准,由于该病变血供极其丰富,是否行术前栓塞目前国内外存在争议,支持术前栓塞者认为其可减少术中失血,反对者认为成本和卒中风险大于收益,本文总结我院CBT无术前栓塞的外科手术治疗经验及术后随访结果,为临床无术前栓塞切除瘤体的安全性提供数据参考。 方法：回顾性分析昆明医科大学第一附属医院血管外科自2017年1月—2020年1月间行手术治疗的65例CBT患者临床与随访资料（其中2例双侧CBT患者选择第一次手术侧的数据）。肿块大小为1.0 cm×0.5 cm×1.0 cm~8.0 cm×6.5 cm×8.5 cm。患者Shamblin分型分别为I型13例,II型33例,III型19例。 结果：65例患者均顺利完成外科手术切除,其中单纯瘤体切除51例（78.46%）,瘤体切除联合单纯颈外动脉结扎8例（12.31%）,瘤体切除联合颈内动脉、颈外动脉切除并颈内动脉重建6例（9.23%）;术中发现术野内淋巴结的患者行淋巴结摘除;术中失血量为10~1 800 mL,平均247 mL。2例双侧病变者均建议择期行对侧手术。病理检查结果,65例均为颈动脉副神经节瘤。围术期1例（1.54%）出现术后脑梗塞死亡。术后14例患者（21.54%）出现迷走神经损伤症状,表现为声音嘶哑、饮水呛咳;5例患者出现舌下神经损伤症状,表现为伸舌偏斜、吞咽困难。2例颈内动脉重建的III型患者（3.08%）术后随访过程中发现颈内动脉闭塞。 结论：CBT确诊后应首选手术治疗,无术前栓塞情况下切除肿瘤安全有效。     

颈动脉转流管在复杂颈动脉体瘤手术切除中的应用

目的:探讨在复杂颈动脉体瘤(CBT)手术过程中应用转流管的安全性及时机选择。方法:回顾性对比分析北京大学人民医院血管外科2002年1月—2018年3月收治的Shamblin Ⅱ、Ⅲ型CBT共85例手术患者的临床资料,其中33例应用转流管(转流管组),另52例未应用转流管(非转流管组),分析、比较两组患者的相关临床资料。结果:转流管组中Shamblin Ⅲ型患者比例明显多于非转流管组(P0.05),其他术前一般资料两组间无统计学差异(均P0.05)。转流管组33例均行颈内动脉重建,大隐静脉补片修补9例,因破裂严重行端端吻合重建共24例;非转流管组52例患者中,2例行颈内动脉重建同时颈外动脉结扎, 14例行单纯颈外动脉结扎,6例行颈外动脉重建。转流管组的手术时间、术中出血、短期神经并发症发生率较非转流管组明显增加(均P0.05),但两组在术后动脉狭窄发生率、长期神经损伤发生率无统计学差异(均P0.05)。结论:复杂Shamblin Ⅱ、Ⅲ型CBT术中采用颈动脉转流是一种安全的治疗手段,不会增加术中心血管系统并发症的风险,同时对长期神经损伤无明显影响。如出现颈动脉破裂可以尽快应用转流管维持颅内血流,可能有助于减少相对的出血及手术时间,同时减少神经不可逆损伤的发生。     

27例颈动脉体瘤的外科诊疗分析

目的总结颈动脉体瘤的诊断、治疗及预防术后并发症的体会。方法回顾性分析笔者所在医院科室于2005年6月至2016年6月期间收治的27例(30个瘤体)颈动脉体瘤患者的临床资料。结果 27例患者中,24例为单侧病变,3例为双侧病变,共计30个瘤体。术前3例行彩超检查,18例行电子计算机断层血管造影(CTA)检查,3例行磁共振血管造影(MRA)检查,6例行数字减影(DSA)检查。Shamblin分型:Ⅰ型10个,Ⅱ型16个,Ⅲ型4个。20个瘤体行单纯瘤体剥离术,6个瘤体行瘤体切除+颈外动脉切除,2个瘤体行瘤体切除+颈内动脉部分切除+颈外-颈内动脉吻合术,2个瘤体行瘤体切除+颈内动脉、颈外动脉及颈总动脉部分切除+颈内-颈总动脉搭桥术。手术均顺利,无一例患者死亡。术后发生偏瘫1例,声嘶2例,饮水呛咳1例。本组27例患者中获访24例,随访时间为3个月~4年,中位数为2.3年。随访过程中,1例偏瘫患者经康复治疗后于术后6个月肌力恢复至3级以上,2例声嘶及1例饮水呛咳患者经对症治疗后于术后2个月恢复正常。24例获访患者随访期间均未复发,无其他并发症发生。结论 CTA和MRA检查有助于颈动脉体瘤的明确诊断,确诊后应积极行手术治疗。     

颈动脉体瘤68例报告

目的:探讨颈动脉体瘤外科手术的经验.方法:总结1962年至1998年收治68例颈动脉体瘤,其中34例(50%)行单纯瘤体剥除,13例(19.1%)行瘤体连同包绕的颈外动脉一并切除,21例(30.9%)行瘤体及包裹的颈内动脉、颈总动脉分叉切除,在这21例中行颈内动脉重建的有18例,颈总动脉或颈内动脉结扎的有3例.结果:手术死亡2例,死亡率为2.9%.术后发生脑梗塞4例.术后并发症中以神经麻痹最多见,共有26例,其中舌下神经15例,迷走神经主干7例,迷走神经分支如咽支、喉上神经等9例,面神经下颌支1例,交感神经8例.结论:颈动脉体瘤因其解剖上的特殊性,使手术有一定的难度.随着手术技术和麻醉方法的改进,颈动脉体瘤手术变得更安全,但术后神经损伤的并发症仍较难控制.     

颈动脉体瘤的外科治疗

目的 探讨颈动脉体瘤的诊断与外科治疗.方法 分析山东大学附属省立医院血管外科2003年1月至2010年10月收治16例颈动脉体瘤患者,经数字减影血管造影术检查得以最终确诊.采用Shamblin分型标准分型:Ⅰ型3例,Ⅱ型11例,Ⅲ型2例,本组全部行外科手术治疗.3例ⅠⅠ型患者行单纯摘除术.11例Ⅱ型患者中,3例行单纯摘除术,3例行摘除术并颈外动脉切除,3例行摘除术、颈外动脉切除并颈动脉修补术,2例行摘除术、颈外动脉切除并颈内动脉重建术.2例Ⅲ型患者,1例行摘除术、颈外动脉切除并颈动脉修补术,1例行摘除术、颈外动脉切除并颈内动脉重建术.结果 16例患者病理均证实为颈动脉体瘤.无手术死亡、偏瘫和失明.术后并发症中以颅神经损伤最多见,共有7例(43.75%),经对症治疗,6例有不同程度改善,1例遗留永久性13角歪斜.随访13例(81.25%),随访时间2～76个月,平均(42.0±1.2)个月,未见肿瘤复发和远处转移.结论 数字减影血管造影术在颈动脉体瘤的诊断和治疗中具有重要意义,颈动脉体瘤应首选手术治疗,可根据瘤体与血管的关系选择适当的术式.

Abstract：

Objective To discuss the diagnosis and surgical treatment for carotid body tumors (CBT). Methods Retrospective analysis was made on 16 cases of carotid body tumors hospitalized in Shandong Provincal Hospital from January 2003 to October 2010. All patients were diagnosed by digital subtraction angiography, including 3 case of Shamblin type Ⅰ,11 cases of Shamblin type Ⅱ and 2 cases of Shamblin type Ⅲ. Three cases of type Ⅰ and 3 cases of type Ⅱ underwent carotid body tumor resection. Three cases of type Ⅱ underwent carotid body tumor plus external carotid artery resection, 3 cases underwent carotid body tumor plus external carotid artery resection plus carotid artery repairment, 2 cases did carotid body tumor plus external carotid artery resection plus internal carotid artery reconstruction. One of type Ⅲ underwent carotid body tumor plus external carotid artery resection plus carotid artery repairment, and the other one underwent carotid body tumor plus external carotid artery resection plus internal carotid artery reconstruction. Results Diagnosis of CBT was confirmed by pathology in all cases. There was no postoperative death、hemiplegia and blindness. The cranial nerve injury was caused in 7 cases, accounting for 43. 75%. 13 cases ( 81. 25% ) were followed up for 2 to 76 months ( mean 42 months), no tumor recurrence and metastasis was found. Conclusions Digital subtraction angiography (DSA) is important in the diagnosis and therapy of carotid body tumor. Surgical treatment is the choice of therapy for carotid body tumors.     

Surgical resection of carotid body paragangliomas: 10 years of experience

Background

Carotid body tumors (CBTs) are relatively rare neoplasms, and even if they are considered predominantly benign, there is an indication for early surgical removal. The objective of this study was to conduct a review of the surgical management of CBTs.

Methods

A retrospective study identified 34 cases (12 men and 19 women) of tumors in patients who had undergone surgical resection of pathologically confirmed CBTs over a period of 10 years from 2001 to 2011 in 2 academic departments of general surgery in Italy.

Results

In our series, 10 CBTs (31%) were Shamblin class I, 13 (41%) were class II, and 9 tumors (27%) were class III. Two patients (6%) had transient cerebral ischemia immediately after operation. One patient (3%) died of postoperative cerebral ischemia after surgery for internal carotid artery thrombosis.

Conclusions

The experience of this casuistry shows that the procedure is relatively low risk for Shamblin I and II classes, whereas there is an increasing risk of neurovascular complications for Shamblin III class.     

Surgical Management of Carotid Body Tumors

Background  Carotid body tumors (CBT) should be considered when evaluating every lateral neck mass. Methods  A retrospective study was conducted of 52 patients with 57 CBT. The surgical approach and complications were reviewed. All patients were operated on without preoperative embolization. Results  Multifocal paraganglioma (PG) were detected in six cases. A succinate dehydrogenase subunit D (SDHD) mutation was discovered in four patients. Vascular peroperative complication occurred in one case. Vascular reconstruction was decided peroperatively in five cases (8.8%). Vascular reconstruction was 0% for Shamblin 1 or 2 tumors, but 28.5% for Shamblin 3. A postoperative nerve paresis was reported in 24 patients (42.1%) and vagal nerve paralysis persisted in four cases (7.01%). The rate of serious complications, e.g., permanent nerve palsy, preoperative and postoperative complications, was 14.03%; it was 2.3% for Shamblin 1 or 2 tumors and 35.7% for Shamblin 3. One patient had malignant PG with node metastasis and was not referred for radiotherapy. No recurrence or metastasis was reported after 6-year follow-up. Conclusion  Early surgical treatment is recommended in almost all patients after preoperative evaluation and detection of multifocal tumors. Surgical excision of small tumors was safe and without complication, but resection of Shamblin 3 tumors can be challenging. Routine preoperative embolization of carotid body paragangliomas is not required.     

Role of Malignancy and Preoperative Embolization in the Management of Carotid Body Tumors

The purpose of this retrospective study is to present our approach to the management of patients with carotid body tumors (CBTs), emphasizing the role of malignancy and preoperative embolization. Between 1975 and 1998 a series of 18 patients with CBTs were treated, and 16 of them underwent successful excision of the tumor. According to the Shamblin classification, six of the tumors were type I, six type II, and six type III. In three of these patients (two with type II tumors and one with type III) in whom preoperative embolization had been performed, mean intraoperative blood loss was 400 ml, whereas in the remaining 13 cases this loss was 700 ml. Two patients with intracranial tumor spread underwent only radiotherapy. Neither postoperative deaths nor strokes occurred. Temporary cranial nerve injury occurred in four cases (25%). Local lymph node invasion was found in two patients, establishing the diagnosis of malignancy. One of these patients developed distal metastases 3 years after the operation and was treated with radiotherapy and octreotide. Follow-up ranging from 30 months to 23 years (mean 5 years) revealed no local recurrence except for the two patients who were treated with radiotherapy only. In conclusion, surgical excision remains the treatment of choice for CBTs and can be performed without major risks and with low morbidity and mortality. Preoperative embolization is helpful by diminishing intraoperative bleeding, and malignancy, though rare justifies early management.     

A multidisciplinary approach to carotid paragangliomas

The surgical management of carotid paragangliomas can be problematic. A multidisciplinary approach was used to include vascular surgery, otolaryngology, and neuroradiology to treat these patients over 9 years. From January 1992 to July 2001, a multidisciplinary team evaluated patients with carotid paragangliomas. Analyzed patient data included age, gender, diagnostic evaluation, tumor size, preoperative tumor embolization, operative exposure, need for extracranial arterial sacrifice/reconstruction, postoperative morbidity including cranial nerve dysfunction, and long-term follow-up. Twenty-five carotid paragangliomas in 20 patients underwent multidisciplinary evaluation and management. Average age was 51 years (range, 28-83 years), and 52% were male. Diagnostic evaluation included computed tomography in 76%, magnetic resonance imaging/magnetic resonance angiography in 52%, catheter angiography in 60%, and duplex ultrasonography in 16%. An extended neck exposure was required in 11 cases (44%), mandibulotomy was used once (4%), and mandibular subluxation was never required. The external carotid artery (ECA) was sacrificed in 8 cases (32%). The carotid bifurcation was resected in 1 patient (4%) requiring interposition reconstruction of the internal carotid artery. Preoperative tumor embolization was performed for 13 tumors (52%). Operative blood loss for patients undergoing preoperative embolization (Group I) was comparable to the nonembolized group (group II): group I lost 365 +/-180 mL versus 360 +/- 101 mL for group II (P = .48). This occurred despite larger tumors (group I - 4.2 cm versus group II - 2.1 cm, P = .03) and a higher mean Shamblin class (group I - 2.5 versus group II - 1.45, P = .001) for group I. There were no perioperative mortalities. Transient cranial nerve dysfunction occurred in 13 CBTs (52%), 2 (8%) of which remained present after 4 months. Patients with carotid paragangliomas benefit from a multidisciplinary team approach. Neuroradiology has been used for selective preoperative embolization, which has decreased estimated blood loss during excision of larger complex tumors. A combined surgical team of otolaryngology and vascular surgery provides for exposure of the distal internal carotid artery as high as the skull base, limited permanent cranial nerve dysfunction, and selective early division and excision of the external carotid artery for complete tumor resection.     

介入联合颈内动脉转流在Ⅲ型颈动脉体瘤切除术中的应用

目的探讨介入联合颈内动脉转流在Ⅲ型颈动脉体瘤切除术中的应用及效果。方法回顾性分析笔者所在医院自2002年1月至2012年7月期间收治的2l例（22侧）Ⅲ型颈动脉体瘤患者的临床资料。21例患者术前经充分评估后,于术前2～3d均用微导管对供瘤血管行超选择栓塞治疗,然后在颈内动脉转流下行颈动脉体瘤切除术。结果21例（22侧）手术均顺利完成,术后经病理学检查证实均为颈动脉体瘤。其中行颈动脉瘤切除术16例（17侧）,瘤体切除＋颈内动脉重建5例（其中自体大隐静脉3例,人工血管2例）。术后当天则出现神经并发症5例（舌歪3例,面部麻木2例）,术后3个月内均恢复正常;无脑梗塞、偏瘫和死亡病例。21例均获随访,随访时间2个月～9年,平均57个月,无复发病例。结论颈动脉体瘤首选的治疗方式是外科切除,介入联合颈内动脉转流下切除Ⅲ型颈动脉体瘤瘤体是安全有效的。     

颈动脉体瘤15例的外科诊治体会

目的探讨颈动脉体瘤的诊断和手术治疗经验。方法回顾性分析1999年9月至2009年12月收治的15例颈动脉体瘤患者的临床资料。9例采用瘤体剥离术,6例行瘤体与所包裹的血管一并切除,切除后因血管长度不够,行血管间置,移植血管替代物中4例选用大隐静脉、1例选用颈外静脉、1例选用人工血管。结果15例术后病理证实为颈动脉体瘤,术后无死亡和偏瘫发生。舌下神经损伤1例,迷走神经损伤2例。结论颈动脉体瘤因为解剖上的特殊性,手术是治疗颈动脉体瘤首选的治疗措施。手术方式的选择应该根据肿瘤与动脉的密切关系来决定。     

Late outcome after surgical management of carotid body tumors from a 20-year single-center experience

Background and aims  Surgical resection is the treatment of choice for carotid body tumors. The aim of this study was to assess not only the perioperative, but also the long-term outcome after surgical treatment. Patients/methods  All patients that were operated on a carotid body tumor at our institution between 1986 and 2006 were reviewed. Data collection included patient profile, intraoperative findings and postoperative outcome. Results  Seventeen patients (11 female, six male) with 17 carotid body tumors (12 right, five left sided) were identified. Mean patient age at treatment was 49 years (range 19 to 76 years). Eight patients (47.1%) had large Shamblin type III tumors. Complete tumor resection was achieved in 16 of 17 cases (94.1%). Malignacy could not be proven in any patient. The 30-day mortality and stroke rates were 0. The incidence of temporary and permanent cranial nerve deficit was 41.2% and 11.8%, respectively. Patients with type III tumors had significantly higher risk of neurologic complications than patients with smaller tumors (p = 0.0152). The median postoperative follow-up was 6.4 years (range 1.5 to 20 years). The overall survival rate was 82.4%; the disease-specific survival rate was 94.1% (16 of 17 patients). One patient (5.6%) died of local tumor recurrence 3 years after a R1 resection. All the other patients showed no signs of local recurrence or metastases. Conclusions  The surgical therapy of carotid body tumors shows low long-term morbidity, mortality, and recurrence rates. Cranial nerve injury is mostly temporary but a relevant procedure-related complication. Surgical resection is indicated also for small, asympomatic tumors, because of the uncomplicated resectability of these tumors. Presented at the Annual Scientific Congress of the German, Swiss and Austrian Societies for Vascular Surgery, Basel Switzerland, September 2007.