Background and Aims: Carotid body tumor (CBT) is a very rare disease in clinical practice, and surgery is the gold standard for the treatment of CBT. As the blood supply of this lesion is extremely abundant, whether or not to employ preoperative embolization is controversial. Proponents of preoperative embolization believe that it reduces intraoperative blood loss, while opponents worry that the costs and risk of stroke outweigh the benefits. This paper summarizes the surgical treatment experience and postoperative follow-up results of CBT in our hospital without preoperative embolization, so as to provide data reference for the safety of surgical resection of the tumor without preoperative embolization. 
Methods: The clinical and follow-up data of 65 patients with CBT undergoing surgical treatment in the Department of Vascular Surgery, the First Affiliated Hospital of Kunming Medical University from January 2017 to January 2020 were retrospectively analyzed (in the two patients with bilateral CBT, the data of the side undergoing the first surgery were selected). The size of the mass was 1.0 cm×0.5 cm×1.0 cm–8.0 cm×6.5 cm×8.5 cm. According to the Shamblin classification, 13 patients had type I lesion, 33 patients had type II lesion, and 19 patients type III lesion.
Results: Surgical resection was successfully performed in all the 65 cases, including simple tumor resection in 51 cases (78.46%), tumor resection combined with external carotid artery ligation was performed in 8 cases (12.31%) and tumor resection combined with external and internal carotid artery resection plus internal carotid artery reconstruction in 6 cases (9.23%). Lymph node dissection was performed in those with lymph nodes found in the operating field during operation. The intraoperative blood loss was 10–1 800 mL, with an average of 247 mL. A second elective surgery for the contralateral lesion was recommended to the two patients with bilateral lesions. Pathological examination revealed that all lesions were carotid paraganglioma. Perioperative death occurred in one patient (1.54%) after the occurrence of postoperative cerebral infarction. After operation, 14 patients (21.54%) had signs of vagus nerve damage, such as voice hoarse and choking when drinking water, 5 patients (7.69%) had symptoms of hypoglossal nerve injury, presented as tongue deflection and swallowing problems. Internal carotid artery occlusion was found in 2 patients (3.08%) with type III CBT undergoing internal carotid artery reconstruction during postoperative follow-up.
Conclusion: Surgical treatment should be the first choice after the diagnosis of CBT. Resection of the tumor without preoperative embolization is safe and effective.