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J Vasc Surg. 2013 Aug;58(2):486-90. doi: 10.1016/j.jvs.2012.11.086. Epub 2013 Feb 11.

Double osteotomy of mandibula in the treatment of carotid body tumors with skull base extension.

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Division of Vascular Surgery, Ospedale S. Carlo Borromeo, Universit√° degli Studi di Milano, Milan, Italy.


We report two patients with a carotid body paraganglioma that extended to the skull base, a position that is surgically inaccessible by means of a traditional lateral cervical approach. In both patients we were able to remove the lesion by performing a double mandibular osteotomy. Both patients underwent preoperative embolization to reduce the mass. In our experience, this approach has allowed a safe radical excision of exceptionally high lesions with only minor permanent nerve damage. In our opinion this advantage definitely outweighs the consequences of the increased invasiveness of this technique.

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