Vascular problems associated with carotid body tumors.

In the last 25 years at the University of Toronto, 27 patients with carotid body tumors were encountered. All patient problems appeared to be related to delay in treatment, size of the tumor, and previous operations. To minimize hazard in this procedure, one should avoid operating on elderly and unfit patients, and otherwise operate early to avoid the problem of a bulky tumor, using a simple subadventitial approach while reserving complete carotid excision and vascular replacement for complicated adherent lesions. Preoperative angiography is mandatory for definitive diagnosis, which permits proper planning of available operating room time, blood replacement, and availability of workers with expertise in vascular surgery. Adequate surgery is effective in tumor clearance, preventing malignant transformation and the lethal effects of local growth.