Hello! I am writing to you to get a better understanding about the complications & risks for my surgery for the neck tumor (carotid body tumor). As I am getting ready for the surgery, the best treatment option available for me at this stage. I was trying to find more information about the complications and risks for this surgery. I have read that it involves a very minor risk of nerve damage, facial paralysis, voice hoarseness, trouble swallowing etc. But it also says that definitely there will be loss of sensation of touch to earlobe and also possibly loss on left side of the neck (near the tumor). I am really very surprised and shocked after I came to know about.
I would like to know your opinion and advice about this please. Please can you list all the major complications of this surgery (earlobe, face), the risks and also the chances or probability or definitely and also the recovery time after surgery. I would like to get a better understanding before I get the surgery date. This will also let me decide my future as to when I will be able to get back to work after surgery (time needed off from work) and with same ability and performance as before the surgery.
Thanks in advance for your time and help regarding this matter.
Dr. Patrick Ha, Head & Neck Surgeon replies...
Carotid body tumors are unusual tumors that can be challenging to resect. However, if it is small enough, then they can successfully be removed and hopefully not cause any problems in the future. Potential complications include serious ones such as stroke, as there will be dissection along the carotid artery, which feeds the blood supply to the brain. The most relevant nerve complications involve cranial nerves 9-12, which control functions such as swallowing, voice, your trapezius muscle (allows you to raise your arm over your head), and your tongue. An additional nerve, the sympathetic nerve, controls the dilation of your pupil, eyelid droop, and sweating on that side of your face. The risk of injury of any of these nerves is low, but cannot be predicted, depending on how adherent the tumor is to these nerves. While there are sensory nerves around the area, depending on how high the tumor goes, it is not always mandatory that the sensory nerve to the ear is cut. There usually is numbness around the operative area for a few weeks to a few months, but that generally will return. Again, while we wouldn't anticipate such problems after such surgery, it is not always predictable.
Let me know if we can be of further assistance to you,
Barbara P. Messing, M.A., CCC-SLP, BRS-S
The Milton J. Dance, Jr. Head and Neck Center
Johns Hopkins Voice Center at GBMC
Board Recognized Specialist in Swallowing Disorders
Clinical Specialist, Head and Neck Rehabilitation
Baltimore, Maryland 21204