Discuss the evolution and differences between classifications for carotid body tumors, including the new Mehanna classification. Review anatomical neck landmarks of Mehanna classification in computed tomography images

Paragangliomas are the most common carotid body tumors. Those are vascular lesions associated with the parasympathetic nervous system, originating from glomus cells within the carotid body, the jugular foramen, the middle ear, and the vagus nerve. The most common site is the bifurcation of the internal and external carotid, which represent 70% of the paraganglioma of the head and neck. [Fig 1] Around 3% of the cases are functional carotid body tumors because they synthesize and secrete catecholamines, which can result in hypertension, headache, heart...

Mehanna classification is a new risk stratification system for carotid body tumors, validated in a multicenter international cohort. It demonstrated better power for predicting complications following surgery, primarily neurological and neurovascular complications, than the widely used modified Shamblin classification system, which has a limited assessment in predicting the risk of neurological damage of cranial nerves. Mehanna classification does not distinguish between the different types of paragangliomas, and it stands for all tumors classified as carotid body tumors involving the carotid bifurcation. The authors hypothesized that...

Mehanna et al. developed and validated a new classification and risk stratification system for carotid body tumors based on the fact that the leading cause of complications was the level of cranial extension. This classification demonstrated better predictive power than the widely used modified Shamblin classification system for the risk of developing neurovascular complications after surgery. As the new classification system uses well-defined anatomical markers on cross-sectional computed tomography or magnetic resonance imaging, it is an easy classification for radiologists with no prior training that...

A. D. P. P. Borges: Nothing to disclose R. Murakoshi: Nothing to disclose C. Toyama: Nothing to disclose R. L. E. Gomes: Nothing to disclose H. Tames: Nothing to disclose E. Gil: Nothing to disclose E. M. M. Gebrim: Nothing to disclose

1 - Mehanna H, Mistry P, Golusinski P, Di Maio P, Nankivell P, Snider F, Ferrante AMR, Montalto N, Nicolai P, Marcantoni A, Grandi C, Zavatta M, Grego F, Malec K, Hosal S, Suslu N, Kuscu O, Torrealba I, Valdes F, Sharma N, Ayuk J, Monksfield P, Irving R, Dunn JA, Kay M, Borsetto D. Development and validation of an improved classification and risk stratification system for carotid body tumors: Multinational collaborative cohort study. Head Neck. 2021 Nov;43(11):3448-3458. doi: 10.1002/hed.26844. Epub 2021 Aug 21. PMID:...