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Microsurgical treatment of large and giant tympanojugular paragangliomas
BACKGROUND: Tympanojugular paragangliomas (TJPs) are benign, highly vascularized lesions located in the jugular foramen with frequent invasion to the temporal bone, the upper neck, and the posterior fossa cavity. Their natural history, surgical treatment, and outcome have been well addressed in the...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287915/ https://www.ncbi.nlm.nih.gov/pubmed/25593763 http://dx.doi.org/10.4103/2152-7806.146833 |
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author | Harati, Ali Deitmer, Thomas Rohde, Stefan Ranft, Alexander Weber, Werner Schultheiß, Rolf |
author_facet | Harati, Ali Deitmer, Thomas Rohde, Stefan Ranft, Alexander Weber, Werner Schultheiß, Rolf |
author_sort | Harati, Ali |
collection | PubMed |
description | BACKGROUND: Tympanojugular paragangliomas (TJPs) are benign, highly vascularized lesions located in the jugular foramen with frequent invasion to the temporal bone, the upper neck, and the posterior fossa cavity. Their natural history, surgical treatment, and outcome have been well addressed in the recent literature; however, there is no consensus regarding the optimal management while minimizing treatment-related morbidity. In this study, we assessed the interdisciplinary microsurgical treatment and outcome of large TJP collected at a single center. METHODS: Out of 54 patients with skull base paraganglioma, 14 (25%) presented with large TJP (Fisch grade C and D). Posterior fossa involvement was present in 10 patients (Fisch D). Eleven patients presented with hearing loss, two patients with mild facial nerve palsy, and two patients with lower cranial nerve deficits. Two other patients with previous surgery presented with tumor regrowth. RESULTS: Preoperative embolization was performed in 13 cases. Radical tumor removal was possible in 10 patients. Hearing was preserved in four patients with normal preoperative audiogram. The facial nerve was preserved in all patients. Temporary facial nerve palsy occurred in two patients and resolved in long-term follow-up. In three patients, preexisting facial nerve palsy remained unchanged. Persistent vocal cord palsy was present in three patients and was treated with laryngoplasty. The global recovery based on the Karnofsky performance scale was 100% in 10 patients and 90% in 4 patients. CONCLUSION: Preoperative embolization and interdisciplinary microsurgical resection are the preferred treatment for selected patients due to high tumor control rates and good long-term results. |
format | Online Article Text |
id | pubmed-4287915 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-42879152015-01-15 Microsurgical treatment of large and giant tympanojugular paragangliomas Harati, Ali Deitmer, Thomas Rohde, Stefan Ranft, Alexander Weber, Werner Schultheiß, Rolf Surg Neurol Int Original Article BACKGROUND: Tympanojugular paragangliomas (TJPs) are benign, highly vascularized lesions located in the jugular foramen with frequent invasion to the temporal bone, the upper neck, and the posterior fossa cavity. Their natural history, surgical treatment, and outcome have been well addressed in the recent literature; however, there is no consensus regarding the optimal management while minimizing treatment-related morbidity. In this study, we assessed the interdisciplinary microsurgical treatment and outcome of large TJP collected at a single center. METHODS: Out of 54 patients with skull base paraganglioma, 14 (25%) presented with large TJP (Fisch grade C and D). Posterior fossa involvement was present in 10 patients (Fisch D). Eleven patients presented with hearing loss, two patients with mild facial nerve palsy, and two patients with lower cranial nerve deficits. Two other patients with previous surgery presented with tumor regrowth. RESULTS: Preoperative embolization was performed in 13 cases. Radical tumor removal was possible in 10 patients. Hearing was preserved in four patients with normal preoperative audiogram. The facial nerve was preserved in all patients. Temporary facial nerve palsy occurred in two patients and resolved in long-term follow-up. In three patients, preexisting facial nerve palsy remained unchanged. Persistent vocal cord palsy was present in three patients and was treated with laryngoplasty. The global recovery based on the Karnofsky performance scale was 100% in 10 patients and 90% in 4 patients. CONCLUSION: Preoperative embolization and interdisciplinary microsurgical resection are the preferred treatment for selected patients due to high tumor control rates and good long-term results. Medknow Publications & Media Pvt Ltd 2014-12-11 /pmc/articles/PMC4287915/ /pubmed/25593763 http://dx.doi.org/10.4103/2152-7806.146833 Text en Copyright: © 2014 Harati A. http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Article Harati, Ali Deitmer, Thomas Rohde, Stefan Ranft, Alexander Weber, Werner Schultheiß, Rolf Microsurgical treatment of large and giant tympanojugular paragangliomas |
title | Microsurgical treatment of large and giant tympanojugular paragangliomas |
title_full | Microsurgical treatment of large and giant tympanojugular paragangliomas |
title_fullStr | Microsurgical treatment of large and giant tympanojugular paragangliomas |
title_full_unstemmed | Microsurgical treatment of large and giant tympanojugular paragangliomas |
title_short | Microsurgical treatment of large and giant tympanojugular paragangliomas |
title_sort | microsurgical treatment of large and giant tympanojugular paragangliomas |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287915/ https://www.ncbi.nlm.nih.gov/pubmed/25593763 http://dx.doi.org/10.4103/2152-7806.146833 |
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