Management of jugular paragangliomas: the Gruppo Otologico experience.
OBJECTIVE
The objective of this study was to review the outcome of surgical management in patients of jugular paragangliomas.


METHODS
We conducted a retrospective case review.


METHODS
Tertiary care otology and skull base center.


METHODS
Fifty-five patients with the diagnosis of a jugular paraganglioma (Fisch Class C and D Glomus Jugulare) were managed over a period of 15 years. All patients with adequate follow up and complete records (53 cases) were reviewed with emphasis on the results of surgical management and the factors influencing them.


METHODS
All 53 patients were managed with a view to surgically extirpate the tumor. The primary approach was the infratemporal fossa approach-Type A used in the majority of the patients. In eight cases, the procedure was staged owing to the presence of large intracranial extension. Three patients required additional procedures to ameliorate the after-effects of lower cranial nerve resection.


RESULTS
Gross total tumor removal was achieved in 49 patients. There were five cases of recurrence. Coupled with the residual tumors in five patients, the surgical control achieved was 83%. There was no perioperative mortality. There were two cases of postoperative cerebrospinal fluid leak, both of which required surgical exploration and closure. The facial nerve was resected in seven patients. The overall preservation rate of clinically uninvolved lower cranial nerves was 75%.


CONCLUSIONS
The low level of complications along with a high surgical control achieved makes surgery the primary mode of treatment in the vast majority of these tumors, regardless of the size and location.
Sanna
Mario
M
Gruppo Otologico, Piacenza-Rome, Italy.
Jain
Yogesh
Y
De Donato
Giuseppe
G
Rohit
Lauda
Lorenzo
L
Taibah
Abdelkader
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003389:Cranial Nerve Diseases / Q000209:etiology; D004621:Embolization, Therapeutic; D005155:Facial Nerve Diseases / Q000209:etiology; D005260:Female; D005925:Glomus Jugulare Tumor / Q000150:complications / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010235:Paraganglioma / Q000150:complications / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D011183:Postoperative Complications; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000150:complications / Q000453:epidemiology / Q000601:surgery* / Q000628:therapy; D013701:Temporal Bone; D016896:Treatment Outcome