Vascular Supply of Laryngeal Paragangliomas:Case Report and Systematic ReviewOA

Objective:Laryngeal paragangliomas are rare,highly vascularized,neuroendocrine tumors.Although surgical resection of these vascular neoplasms is associated with a known risk of significant hemorrhage,the vascular supply of laryngeal paragangliomas has been poorly characterized.Data Sources:MEDLINE Ovid,Embase,Scopus,and Google Scholar.Methods:Databases were searched using specific strategies.English articles describing laryngeal paragangliomas with named vascular supply were included.Data from articles that met inclusion criteria were extracted and analyzed.Results:Twenty-three articles met inclusion criteria,including 26 laryngeal paragangliomas with named vascular supply,with one additional case reported by the authors.Mean age was 50.2 years,and 19(70.4%)patients were female.Twenty-five(92.6%)laryngeal paragangliomas were supraglottic,while 2(7.4%)subglottic.Vascular supply was most commonly from the superior thyroid artery in 23(85.2%)cases,and 4 cases(11.5%)reported bilateral vascular supply.Twenty-six(96.3%)paragangliomas were surgically resected,with preoperative angiography and embolization performed in 14(51.9%)cases.Conclusions:Laryngeal paragangliomas are highly vascular tumors,which may have bilateral vascular supply in 11.5%of reported cases.Routine angiography with embolization during preoperative evaluation is recommended to assess and control potential contralateral contributions and reduce intraoperative hemorrhage during surgical resection.Summary Although infrequently reported,this study provides a novel review of laryngeal paragangliomas,with particular focus on their vascular supply.This is important to guide recommendations surrounding preoperative evaluation.Laryngeal paragangliomas may have bilateral vascular supply in 11.5%of reported cases.Routine angiography with embolization during preoperative evaluation may control potential contralateral contributions and reduce intraoperative hemorrhage during surgical resection.