Carotid baroreceptor dysfunction after carotid body tumour resections

Area of Science:

• Cardiovascular Physiology
• Surgical Oncology
• Autonomic Neuroscience

Background:

• Carotid body tumors (CBTs) are rare neoplasms affecting the carotid body.
• Baroreceptor failure (BRF) is a distinct condition impacting cardiovascular regulation.
• The relationship between CBTs and BRF, particularly after surgical resection, requires further elucidation.

Purpose of the Study:

• To describe and quantify baroreceptor failure (BRF) following unilateral and bilateral carotid body tumor (CBT) resections.
• To analyze changes in BRF characteristics and autonomic dysfunction subtypes post-surgery.

Main Methods:

• Prospective cohort study including patients undergoing CBT resection (April 2021-January 2023).
• Baroreceptor sensitivity assessed using the Composite Autonomic Severity Score (CASS).
• Statistical analysis performed using R with a significance level of α = 0.05.

Main Results:

• 23 patients (18 unilateral, 5 bilateral CBTs) were analyzed; all were female, median age 60.
• Preoperatively, 13/18 unilateral CBT patients had BRF (mixed subtype most common). Postoperatively, sympathetic failure was most common.
• After bilateral CBT resection, most patients persisted with BRF, with only one remaining without autonomic dysfunction.

Conclusions:

• Baroreceptor failure (BRF) is prevalent preoperatively in CBT patients and often persists post-resection, with altered dysfunction characteristics.
• No significant associations were found between BRF type/severity and tumor classification or laterality.
• Continued research is crucial to understand CBT pathogenesis and its effects on BRF and quality of life.