2026 Poster Presentations
P468: BAROREFLEX FAILURE AFTER SURGICAL RESECTION OF BILATERAL CAROTID BODY TUMORS: A SYSTEMIC REVIEW
Alex Z Graboyes1; Aleena A Abbasi, BS2; Christopher H Rassekh, MD1; Jason A Brant, MD3; Visish M Srinivasan, MD4; Michelle Alonso-Basanta, MD, PhD2; Yonghong Huan, MD5; 1Department of Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104; 2Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104; 3Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792; 4Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104; 5Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
Background: Carotid Body Tumors (CBTs) are a rare type of head and neck neuroendocrine tumor in the head and neck, arising from the paraganglionic tissues at the bifurcation of the common carotid artery. Baroreceptors are embedded within each side of the carotid sinus and aortic arch. Baroreceptor failure (BRF) can be debilitating, as it causes autonomic instability and excessive fluctuations in blood pressure (BP) and heart rate (HR).
Methods: In June 2024, a systematic review was commenced, among PubMed/Medline, Scopus, and Cochrane library databases using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Co-first authors, AZG and AAA, were responsible for review, with senior author, YH, serving as an adjudicator.
Results: The review only included 15 single case reports and 8 case series of BRF in surgical resection of bilateral CBTs. No higher quality studies of clinical trials or cohort studies were available. Results from this review showed that the onset of BRF symptoms usually occurs immediately after the second surgery in bilateral resection of CBTs, and most cases of BRF seemed self-limiting with quick resolving/improving clinical courses. Commonly used treatments of BRF were clonidine and benzodiazepine. Most reported cases involved adults, with ages ranging from 15 to 63 years at the time of their first CBT resection, though three were pediatric patients.29-31 There was a female predominance in the reported cases both among single case reports and case series. Genetic information was only provided in one case series published in 2016 while 7 single case reports and 5 case series provided information on family history.29 The reported tumor sizes ranged from 1.0 cm to 8.3 cm by their largest dimension, though many studies did not provide information on tumor sizes.
Conclusions: Despite the commonly perceived high risk and debilitating clinical outcomes, the observed risk and outcome of BRF seems more tolerable in surgical resection of bilateral CBTs. The optimal management of CBTs remains unclear, though surgical resection of bilateral CBTs warrants consideration on an individual basis.