{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:30:17Z","timestamp":1789590617798,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,6,3]],"date-time":"2018-06-03T00:00:00Z","timestamp":1527984000000},"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":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to evaluate the risk associated with different types of surgery for carotid body paraganglioma of different Shamblin class. A meta\u2010analysis was conducted to evaluate per tumour class, the local control, cranial nerve damage and complication rates of different techniques using internal carotid artery (ICA) and external carotid artery (ECA) ligation, clamping or bypassing, as well as the craniocaudal vs caudocranial techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A meta\u2010analysis is conducted after a systematic search in PubMed and the Cochrane library, in accordance with the PRISMA guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Local control, cranial nerve damage, complications, function recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 3565 articles, 27 were selected. The overall quality of evidence of studies was low. Cranial nerve damage (3%, 17% and 39%) and complication rates (0%, 1% and 10%) were significantly related to Shamblin class (class 1, 2 and 3, respectively, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01). For class 3 tumours, an increased risk of complications was found associated with routine ICA manipulation\/reconstruction (RR 3.12 with a 95% CI of 1.29\u20107.59), as well as a trend towards enhanced risk of routine ECA ligation (RR 3.48 with a 95% CI of 0.88\u201013.81).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For class 1 and 2 tumours, surgery seems a viable treatment option. For class 3 tumours, morbidity in terms of cranial nerve deficit and complications is considerable; particularly, the use of ICA manipulation\/reconstruction and potentially ECA ligation seem to be accompanied by high stroke incidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13116","type":"journal-article","created":{"date-parts":[[2018,4,15]],"date-time":"2018-04-15T23:49:40Z","timestamp":1523836180000},"page":"1104-1116","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A meta\u2010analysis on the surgical management of paraganglioma of the carotid body per Shamblin class"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4842-6954","authenticated-orcid":false,"given":"T.T.G.","family":"Jansen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Head &amp; Neck Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.A.M.","family":"Marres","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head &amp; Neck Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.H.A.M.","family":"Kaanders","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.P.M.","family":"Kunst","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head &amp; Neck Surgery Radboudumc Skull Base Centre Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23436"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000615)88:12<2811::AID-CNCR21>3.0.CO;2-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2384-5"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2004.06.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01878.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-9977-z"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181656cc0"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13046"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(71)90436-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/153857440203600405"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(81)90349-4"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-011-0461-x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1092"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-3-10"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2013.08.010"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.10.075"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.03.037"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200210000-00034"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.10.012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200303000-00026"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.06.002"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/08998280.2016.11929343"},{"key":"e_1_2_8_25_1","first-page":"1109","article-title":"Paraganglioma of the neck. 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