We would like to thank the authors for their interest and constructive comments[1] for our article entitled "Para-aortic paraganglioma: Preoperative embolization and surgical resection".[2] We have carefully reviewed your 1997 report on four cases of carotid body and jugular bulb paragangliomas, as well as the other references you cited.[2-5] Your observation that preoperative neuroendocrine functional evaluation should be more detailed in such carotid body tumors is entirely valid. The literature reports that intraoperative hemodynamic complications are particularly common in such cases, and we have encountered similar issues in our own surgical practice. Therefore, we believe that a multidisciplinary approach is crucial for achieving optimal surgical outcomes. Although no complications occurred in our present case, severe events requiring pacemaker support remain a possibility.

In this case, we did not present detailed information on preoperative biochemical evaluation, as the patient was referred to us from an external center for surgical resection after already undergoing this evaluation. Since such cases usually present to surgical clinics with biochemical work-up already completed, this case, as you rightly pointed out, has been discussed less frequently in the surgical literature. For the same reason, we did not elaborate on it in our article. However, following the patient"s discharge, we referred them back to the endocrinology unit, and their postoperative biochemical follow-up is still ongoing.

Data Sharing Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author Contributions: All authors contributed equally to this article.

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Funding: The authors received no financial support for the research and/or authorship of this article.

References

1) Alebrahim K. Comment to the article: Preoperative planning in paraganglioma resection: Evolving strategies for safer outcomes. Turk Gogus Kalp Dama 2025;33(4):585. doi:10.5606/tgkdc.dergisi.2025.28432.

2) Reyhanoğlu H, Çakır V. Para-aortic paraganglioma: Preoperative embolization and surgical resection. Turk Gogus Kalp Dama 2025;33:382-5. doi: 10.5606/tgkdc. dergisi.2025.26752.

3) al-Ebrahim K, el-Azm M, el-Kholy A, Shafei H. Arterial and venous paragangliomas: the value of a preoperative pacemaker and a multidisciplinary approach. Br J Neurosurg 1997;11:233-7. doi: 10.1080/02688699746302.

4) Ayala-Ramirez M, Feng L, Johnson MM, Ejaz S, Habra MA, Rich T, et al. Clinical risk factors for malignancy and overall survival in patients with pheochromocytomas and sympathetic paragangliomas: primary tumor size and primary tumor location as prognostic indicators. J Clin Endocrinol Metab 2011;96:717-25. doi: 10.1210/jc.2010- 1946.

5) Fishbein L. Pheochromocytoma and paraganglioma: Genetics, diagnosis, and treatment. Hematol Oncol Clin North Am 2022;36:735-54. doi: 10.1016/j.hoc.2022.04.003.