Carotid Body Tumor Surgery in Turkey (Istanbul) — Awake/Local Anesthesia

What Is a Carotid Body Tumor?

The carotid body is a small chemoreceptor located where the common carotid artery divides into the internal and external carotid arteries. A carotid body tumor (also called a carotid paraganglioma or glomus caroticum) arises from these cells. It is uncommon and, in the large majority of cases, benign — though it can slowly enlarge and, in a small percentage, behave more aggressively. Because of its location, it grows between the two carotid branches and pushes them apart (the radiological “lyre sign”).

Causes and Hereditary Forms

Most carotid body tumors occur sporadically, but a notable proportion are hereditary. Mutations in the succinate dehydrogenase (SDH) genes can run in families and cause paragangliomas — sometimes on both sides of the neck or in more than one site. Long-term low-oxygen exposure (for example living at high altitude or chronic lung disease) is also associated with carotid body enlargement.

• Family history: A paraganglioma in a close relative raises the likelihood of a hereditary form; genetic counseling may be advised.
• Bilateral or multiple tumors: More common in hereditary cases.
• Chronic hypoxia: High-altitude living or chronic low-oxygen states are associated risk factors.

Symptoms

Most carotid body tumors present as a painless, slowly growing mass on the side of the neck. Some patients notice a pulsatile swelling. Less commonly, dizziness, fainting, or — with larger tumors — difficulty swallowing or hoarseness due to pressure on nearby nerves may occur. Many are discovered incidentally during a neck examination or imaging.

Diagnosis

Diagnosis begins with a clinical examination and color Doppler ultrasound, followed by CT or MR angiography to map the tumor and its relationship to the carotid arteries. This imaging is essential for planning a safe operation and for determining the Shamblin grade.

Shamblin Classification

Surgical planning depends on how much the tumor encases the carotid artery, described by the Shamblin classification:

• Shamblin I: Small tumor that touches but does not encase the artery; relatively straightforward removal.
• Shamblin II: Partially encases the carotid artery; careful dissection required.
• Shamblin III: Fully surrounds the artery; the most challenging group, where vascular repair/reconstruction may be needed.

Treatment: Surgical Removal

Complete surgical removal is the main, curative treatment for a carotid body tumor whenever it is technically feasible. The key principle is to remove the tumor without injuring the carotid artery or the adjacent cranial nerves. In selected cases, pre-operative embolization (reducing the tumor’s blood supply) can make the operation safer. In appropriate patients, parts of the procedure can be performed under local anesthesia so that the patient’s neurological responses are monitored during surgery. Radiotherapy is generally reserved for patients who are not suitable candidates for surgery.

Local (Awake) Anesthesia: Why It Matters

In suitable patients, Prof. Dr. Yusuf Kalko removes carotid body tumors under local (awake) anesthesia. The main advantages of this approach are:

• Because the patient is awake, brain function and nerves can be monitored in real time during surgery.
• This monitoring may help minimize the risk of stroke and cranial-nerve injury.
• It avoids the side effects and risks of general anesthesia — particularly valuable in older patients or those with other health conditions.
• The operation can be guided according to the patient’s real-time condition.
• In suitable cases, a more comfortable process and earlier recovery.

Whether this approach is suitable is decided individually by the physician.

Why and When Should It Be Treated?

Carotid body tumors usually grow slowly but rarely shrink on their own. As they enlarge they encase the carotid artery and nearby nerves more closely, which makes surgery more complex and increases risk. For this reason, removal is often recommended earlier — while the tumor is still a lower Shamblin grade — particularly in younger, fit patients. A small percentage can be malignant or hormonally active, which is a further reason for proper evaluation.

What to Expect: Surgery and Recovery

The operation is carried out through an incision on the side of the neck, under general or — in suitable patients — local anesthesia. The surgeon carefully separates the tumor from the carotid arteries and cranial nerves; in higher Shamblin grades a segment of the artery may need to be repaired or reconstructed. Most patients have a short hospital stay.

After surgery, some patients have temporary difficulty swallowing or a change in voice due to nerve irritation, which usually improves over time. Your team arranges follow-up, and in hereditary cases periodic surveillance of the opposite side and neck.

Risks and Outlook

• Cranial nerve injury (affecting voice, swallowing or tongue/shoulder movement) — usually temporary, occasionally lasting.
• Bleeding and, in higher grades, the need for arterial repair.
• Stroke risk, higher in Shamblin III where the internal carotid is involved.

The overall outlook is generally very good: complete surgical removal is curative in most benign tumors. Careful planning by an experienced vascular team is what keeps these risks low.

Who Should Perform the Surgery?

Because the central challenge is protecting and, if necessary, repairing the carotid artery, this operation is best planned by a team experienced in vascular surgery and arterial reconstruction. Prof. Dr. Yusuf Kalko brings extensive cardiovascular surgery experience and a vessel-preserving approach to these procedures.

International Patients

Prof. Dr. Yusuf Kalko evaluates and treats patients in Istanbul, Turkey and welcomes international patients. If you have a neck mass or imaging suggestive of a carotid body tumor, you can share your reports with us for an initial assessment and a treatment plan.

How to start:

1. Send your recent neck ultrasound and CT/MR angiography reports (and images if possible) via WhatsApp or e-mail (info@yusufkalko.com).
2. We review them and share an initial assessment and a possible treatment plan.
3. If surgery is appropriate, we help you plan the timing and your visit to Istanbul.

Why Choose Turkey (Istanbul) for Your Treatment?

• Over 30 years of experience in cardiovascular and vascular surgery.
• Advanced minimally invasive and hybrid techniques.
• English- and Arabic-speaking support for international and Gulf patients.
• Competitive costs and easy access to Istanbul from the Gulf, Europe and beyond.
• Pre-travel remote assessment, then treatment and appointment planning.

How to Start from Abroad (Remote Consultation)

You can send your medical reports and scan images via WhatsApp for an initial assessment before traveling. We then plan your treatment and appointment in Istanbul, Turkey, and support international patients at every step.

Frequently Asked Questions

Related

• Carotid Artery Disease & Stroke Prevention
• About Prof. Dr. Yusuf Kalko
• Contact

This page is for information only and does not replace a medical examination. Diagnosis and treatment are determined by a physician. — Prof. Dr. Yusuf Kalko, Cardiovascular Surgeon