Abstract
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.
Highlights
Paragangliomas have their origin in paraganglia of the chemoreceptor system
We present preoperative evaluation, surgical treatment, follow‐up management, and long‐term results for 14 patients with large Tympanojugular paragangliomas (TJPs) (Fisch Class C and D) treated at a single center
Radical tumor resection was achieved in 10 patients
Summary
Tympanojugular paragangliomas (TJPs), known as glomus jugulare tumors, arise from a small group of cells in the adventitia of the jugular bulb. Despite their benign origin, they represent locally aggressive, destructive neoplastic lesions, with frequent invasion of the middle ear, the temporal bone, the upper neck, and through the jugular foramen (JF) into the posterior cranial fossa. 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; there is no consensus regarding the optimal management while minimizing treatment‐related morbidity. We assessed the interdisciplinary microsurgical treatment and outcome of large TJP collected at a single center
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