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[Baroreflex failure after chemodectoma resection].

J C Gómez Esteban1, S Boyero, C Fernández

  • 1Servicio y Cátedra de Neurología, Hospital de Cruces, Departamento de Neurosciencias, Universidad de País Vasco, Baracaldo, Vizcaya. igomeze@meditex.es

Neurologia (Barcelona, Spain)
|October 8, 2004
PubMed
Summary
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Baroreflex failure can occur after carotid body tumor surgery due to glossopharyngeal nerve injury. Unilateral nerve damage, not just bilateral, can cause this condition, leading to blood pressure instability.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Surgical Oncology

Background:

  • Chemodectomas, also known as paragangliomas, are rare neuroendocrine tumors often arising in the head and neck region.
  • Surgical resection is the primary treatment for chemodectomas.
  • The glossopharyngeal nerve (CN IX) plays a crucial role in cardiovascular regulation, including baroreflex function.

Observation:

  • A patient developed symptoms of baroreflex failure, including presyncope, hypertensive crises, and tachycardia, months after surgery for a left-sided carotid body chemodectoma.
  • These episodes were triggered by mental stress and postural changes (standing up).
  • Resting blood pressure was noted to be below normal ranges.

Findings:

  • The patient's symptoms were diagnosed as baroreflex failure resulting from a unilateral injury to the glossopharyngeal nerve during surgery.

Related Experiment Videos

  • This case demonstrates that baroreflex failure can develop even with injury to only one glossopharyngeal nerve.

    • Implications:

    • Unilateral glossopharyngeal nerve injury is sufficient to cause significant baroreflex dysfunction.
    • Clinicians should consider baroreflex failure in patients presenting with autonomic instability post-chemodectoma resection, even without bilateral nerve involvement.
    • Awareness of this complication is crucial for patient management and monitoring after head and neck tumor surgery.