Vascular Supply of Laryngeal Paragangliomas: Case Report and Systematic Review

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.