Jugulotympanic paraganglioma: A cause of sequential cranial nerve fallout and obstructive hydrocephalus

Abstract

Abstract A 46-year-old male presented with a longstanding history of a sequential cranial nerve fallout. Following extensive imaging which included contrast enhanced computed tomography, computed tomography angiography, and diagnostic digital subtraction angiography, a diagnosis of jugulotympanic paraganglioma was made. The tumour was found to be locally invasive, encapsulating major neurovascular structures and ultimately inaccessible. Furthermore, the clinical presentation was complicated by acute obstructive hydrocephalus secondary to tumour mass effect. Given the rarity of the condition and unusually extensive presentation, neurosurgery alongside a multidisciplinary team collaborated to formulate a management plan aimed at maximizing functional outcome and minimizing intraoperative morbidity. A decision was made to perform palliative surgical debulking procedure followed by multidisciplinary care and rehabilitation. The patient demised in the care of his family prior to any further intervention.