I read your input on a blog and If it is not too much to ask I would like to ask you a few questions. My friend has a carotid body tumor of 2 inches. He was told by the vascular surgeon that if the tumor is in the nerve he will experience hoarseness in his voice permanently. If the tumor is in the artery he does not run this risk. I was wondering what is the likeliness of experiencing permanent hoarseness and are there any treatments that help repair the voice? Any information would be greatly appreciated.
Patrick Ha, MD FACS replies...
Carotid body tumors are unusual tumors that can affect the crook of where the internal and external carotid arteries split in the upper neck. The vagus nerve that you are talking about runs within the sheath of the carotid artery, along with the jugular vein. Generally speaking, the vagus nerve is not entwined in these tumors and can therefore be carefully dissected free of the tumor. However, as this nerve is always present in this region, there is a small chance that even retracting on the nerve may cause some injury, but this would generally be temporary, and not permanent.
Should a permanent injury occur, the consequences may be difficulty in swallowing, as the vagus nerve does control many of the muscles that help to coordinate swallowing. Generally, younger individuals can compensate, but this may require some additional therapy with the assistance of trained speech language pathologists. The voice will also be hoarse because of its contributions to the muscles that control the vocal cords. Should this be permanently injured, the hoarseness can be ameliorated by procedures on the vocal cord (a vocal cord medialization procedure), that can be temporary (in injection form), or if needed, a permanent implant can be inserted.
Patrick Ha, MD FACS
Johns Hopkins Department of Otolaryngology
Johns Hopkins Head and Neck Surgery at GBMC