Baroreflex failure after surgical removal of bilateral carotid body tumours

Abstract

Objective. The assessment of complications after removal of bilateral carotid body tumours with special attention to the occurrence of baroreflex failure. Materials and methods. Illustrated by three cases, the symptomatology and the diagnostic and therapeutic consequences and the possible remaining morbidity are investigated. Results. The most important complications of carotid body surgery are cranial nerve palsy and cerebrovascular accidents. Failing baroreflex after bilateral removal of carotid body tumours is an only occasionally reported complication. Its appearance is caused by denervation of the afferent innervation of the carotid sinus and the carotid body. Allthough this complication is rare, the consequences to a patient can be considerable. The symptomatology is dominated by a severe, labile hypertension. The accompanying symptoms can include headaches, palpitations, flushing, diaphoresis and emotional lability. The severity and duration of the complaints vary considerably from patient to patient. Treatment with antihypertensive medication can greatly reduce the symptoms.s New Roman Conclusion. Failure of the baroreflex after bilateral removal of carotid body tumours is a rare complication. Nevertheless it can give rise to serious complications which can be hard to treat. Patients undergoing removal of a second carotid body tumour should be made aware of this possible complication.