A two years prospective follow up and outcome of patients operated for carotid body tumors: experience from Ethiopia.

OBJECTIVE

We aimed to describe the patterns of patient presentation, management and prospective two-year follow up at the Tikur Anbessa Hospital.

INTRODUCTION

Carotid body tumors (CBTs) constitute about 80% of paragangliomas and they occur frequently in Ethiopia.

METHODOLOGY

This is a two years prospective study, involving all patients operated from September 2007-August 2009 (over a two year period) at the Tikur Anbessa Hospital, Addis Ababa, Ethiopia for CBTs. Routine patient characteristics along with details of presentation, diagnostic tools employed, preoperative and post operative management, intra-operative staging and postoperative complications were recorded. All patients were followed post operatively for an average of 13 months. Data was prospectively collected and analysis done.

RESULTS

A total of 19 patients were admitted and operated. All patients presented with a painless slowly growing neck mass. The tumor was situated in the left side in 12 (63.2%) and was bilateral in only 1 (5.2%). The preoperative diagnosis was suspected by clinical examination in all patients and confirmation done with fine needle aspiration cytology (FNAC) in 18 (94.7%) and doppler ultrasound in 12 (57.9). No patient required vascular bypass or deliberate resection and reconstruction of the carotid artery during surgery. Staging of the tumor showed 5 (26.3%) were Shamblin I, 10 (52.6%) were Shamblin II and 4 (21.1%) were Shamblin III. Five (26.3%) of the patients had evidence of temporary nerve injury. Malignancy was not diagnosed in any of the patient. Nine (47.4%) of the procedures were complicated by bleeding in excess of 500 ml and mortality was 0%.

CONCLUSION

The experience in carotid body tumor excision at our center is encouraging and our surgical management of carotid body tumors had good long term outcome and low complication rates.