Maturo Stephen, Brennan Joseph
Department of Otolaryngology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas 78236-5550, USA.
Laryngoscope. 2006 May;116(5):829-30. doi: 10.1097/01.mlg.0000205130.92277.02.
Multiple head and neck paragangliomas are a rare occurrence. We report a patient with removal of bilateral carotid paragangliomas who subsequently developed baroreflex failure 1 month after surgery. The pathology and physiology of this presentation is extremely interesting because it exhibits the complex homeostatic mechanisms involved in the maintenance of steady-state blood pressure. Although rare, it is important to be aware of baroreflex failure and its variable course. Most postsurgical cases occur within days of surgery but, as this report demonstrates, hypertensive urgency can occur weeks to months after surgery; and if not recognized early, it can lead to disastrous postoperative complications such as stroke and myocardial infarction.
多发性头颈部副神经节瘤较为罕见。我们报告一例双侧颈动脉副神经节瘤切除术后1个月出现压力反射衰竭的患者。这种表现的病理生理学极其有趣，因为它展示了维持稳态血压所涉及的复杂稳态机制。尽管罕见，但了解压力反射衰竭及其多变病程很重要。大多数术后病例发生在术后数天内，但正如本报告所示，高血压急症可在术后数周甚至数月出现；若不及早识别，可能导致灾难性的术后并发症，如中风和心肌梗死。
