{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T02:43:57Z","timestamp":1774406637170,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T00:00:00Z","timestamp":1663718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Present the feasibility, applicability, clinical effectiveness, and results of complicated Shamblin II or III carotid body tumors treated with a two\u2010stage hybrid surgical approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Retrospective, observational, cross\u2010sectional, descriptive study of the successful treatment of 16 cases of difficult Shamblin II or III carotid body tumors, consisting of a two\u2010stage surgical approach. We conducted a retrospective, observational, cross\u2010sectional, descriptive study of a series of patients with complicated Shamblin II or III carotid body tumors, which we treated with a two\u2010stage hybrid surgical procedure, in which we first placed a carotid endoprosthesis and 45\u2009days later performed surgical resection of the tumor, following our originally published technique. This study was conducted from February, 2007 to November, 2019, in a third level care centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We treated 16 patients with a mean age of 50.5\u2009years. All resided at more than 2000 meters above sea level. In all 16 a complete resection was performed. The average duration of surgery was 103.9\u00a0min, the average intraoperative bleeding was 69\u2009ml. There were three cases of neuropraxia. The ansa cervicalis nerve had to be sectioned in three cases and there was permanent upper laryngeal nerve injury in two cases. There were no permanent cerebrovascular injuries from placement of the endoprostheses. One patient developed transient cerebral ischaemia (TIA) with no long\u2010term sequelae. There were two cases of asymptomatic late occlusion of the endoprostheses. The average initial volume of the tumors was 54.4\u00a0cc. The average tumor volume 35\u2009days after implant of the endoprosthesis was 30.9\u00a0cc.<\/jats:p><\/jats:sec><jats:sec><jats:title>Symptoms<\/jats:title><jats:p>Presence of tumors in the neck in all cases and two cases of dysphagia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This two\u2010stage hybrid technique allowed for the complete resection of difficult Shamblin II or III carotid body tumors, with one case of TIA and two with permanent upper laryngeal nerve injuries and without mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27190","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T10:53:56Z","timestamp":1663757636000},"page":"2803-2809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Two stage, hybrid endovascular and open surgical approach to treat difficult carotid body tumors"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-4688","authenticated-orcid":false,"given":"Gustavo","family":"Fink\u2010Josephi","sequence":"first","affiliation":[{"name":"Vascular Surgery Service Hospital Angeles Lomas  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2387-2023","authenticated-orcid":false,"given":"Luis Mauricio","family":"Hurtado\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"General Surgery Service Hospital General de M\u00e9xico  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo Francisco","family":"Hern\u00e1ndez\u2010Valencia","sequence":"additional","affiliation":[{"name":"Neurosurgery Service Hospital General de M\u00e9xico  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas Antonio","family":"Higuera\u2010Calleja","sequence":"additional","affiliation":[{"name":"Neuroradiology Division Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guadalupe","family":"Guerrero\u2010Avenda\u00f1o","sequence":"additional","affiliation":[{"name":"Neurosurgery Service Hospital General de M\u00e9xico  Mexico City Mexico"},{"name":"Interventional Radiology Service Hospital General de M\u00e9xico  Mexico city 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