Surgical Safety and Preservation of Quality of Life in Carotid Body Tumour Resection: The Role of Embolisation and Vulnerability Analysis in Working-Age Patients

Background/Objectives: Carotid body tumour (CBT) resection carries substantial haemorrhage and cranial neuropathy risks. While preoperative embolisation mitigates these, its impact on patient-reported outcomes (PROMs) and quality of life (QoL) remains underexplored. Evaluate the preoperative embolisation’s impact on postoperative QoL using the 36-Item Short Form Health Survey (SF-36) questionnaire. Methods: A retrospective cohort study (68 patients) compared Preoperative Embolisation (Group E, n = 24) and Primary Resection (Group NE, n = 44), adjusting for confounders via multivariate linear regression. Results: Group E featured larger, more complex tumours. Despite this structural burden, intraoperative bleeding was significantly lower in Group E (median 300, Interquartile Range (IQR) 150–400 vs. 400 mL, IQR 350–500; p = 0.012). Group E reported lower overall median SF-36 scores (59.5 vs. 70 points; p = 0.002); however, multivariate analysis confirmed that embolisation was not an independent negative QoL predictor (b = −0.52, p = 0.852), whereas Shamblin grade III was associated with diminished well-being (b = −7.42, p = 0.012). Domain analysis revealed selective restrictions driven by acute somatic and emotional stress: Physical Functioning (p = 0.002), Bodily Pain (p = 0.007), General Health (p = 0.003), Vitality (p = 0.016), and Role Emotional (p = 0.010). Age stratification revealed a non-linear trend, validated via ANOVA (p = 0.013): working-age patients (<60 years) exhibited significantly lower SF-36 scores (61.2 ± 11.4 points) than the intermediate (p = 0.034) and elderly (p = 0.011) subgroups (>70 years; 72.8 ± 5.1 points). Conclusions: Preoperative embolisation optimises hemodynamic control and surgical safety without independently compromising long-term well-being. Postoperative QoL is heavily modulated by age-dependent generational psychosocial baselines rather than structural morbidity metrics alone.