Carotid baroreceptor dysfunction after carotid body tumour resections.

Autor: Mier Y Teran-Ellis S; Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico; Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de La Salud, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico; Vascular & Endovascular Surgery Program, The University of Edinburgh, Edinburgh, Scotland, UK., Bobadilla-Rosado LO; Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico., Anaya-Ayala JE; Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico; Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de La Salud, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico., Estrada-Rodriguez HA; Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico., Dominguez-Vega RX; Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico., Gonzalez-Duarte A; Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; Department of Neurology at New York University Grossman School of Medicine, New York, NY, USA., Hinojosa CA; Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico; Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de La Salud, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico. Electronic address: carlos.a.hinojosa@gmail.com.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Oct; Vol. 50 (10), pp. 108550. Date of Electronic Publication: 2024 Jul 14.
DOI: 10.1016/j.ejso.2024.108550
Abstrakt: Objective: Carotid body tumours (CBTs) and baroreceptor failure (BRF) are two distinct but interrelated conditions, affecting the carotid body and its regulatory mechanisms. We aim to describe and quantify BRF after unilateral and bilateral CBT resections.
Methods: Prospective cohort study. We included all patients with unilateral or bilateral CBT undergoing resection from April 2021 to January 2023. Demographics and CBTs characteristics were analysed; baroreceptor sensitivity assessment was conducted using the Composite Autonomic Severity Score (CASS). Statistical analyses were performed using R. Significance level was set at a 2-tailed α = 0.05.
Results: A total of 30 patients with CBT underwent surgical resection, twenty-three were included in the study (18 unilateral and 5 bilateral CBTs). All 23 (100 %) were females, median age of 60 years. Regarding patients with unilateral CBT; preoperatively, 13 had BRF, the most common dysfunction subtype was mixed. Postoperatively, the most common dysfunction subtype was sympathetic failure. With regards to bilateral CBTs; 2 patients did not have autonomic dysfunction preoperatively. After bilateral surgical resection one patient remained without autonomic dysfunction; however, all other patients persisted with BRF.
Conclusion: BRF was present in 13 patients with unilateral CBT and 3 patients with bilateral tumours preoperatively; most will remain with BRF and will only change the characteristics postoperatively. No associations were found between type, severity of BRF and Shamblin classification or laterality. It is paramount that research in this area continues as many features are yet unknown regarding CBT pathogenesis, hence, BRF may be present yet not affect significantly quality of life.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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