title: [Head and neck paragangliomas: revision of 89 cases in 73 patients].
abstract: BACKGROUND
  Paragangliomas (PGL) are uncommon neuroectodermal tumours. PGL are usually clinically benign tumours, although metastasis has been reported and invasive growth can occur in adjacent tissues (<10 %). Mutations in SDHB, SDHC, and SDHD, which encode sub-units of mitochondrial complex II (succinate dehydrogenase), play an important role in the pathogenesis of these tumours.
  
  
  METHODS
  Retrospective review of 73 patients with 89 paragangliomas who had undergone resection of the PGL in our hospital. There were 8 patients who displayed multiple PGL. PGL were distributed as follows: 33 were jugular, 17 tympanic, 26 carotid body tumours, and 13 vagal paragangliomas. All these patients had a follow-up time of at least a year. The surgical approach was evaluated in terms of tumour origin, sequelae, and subsequent evolution, as well as the relapses and their relation with location of the primary tumour.
  
  
  RESULTS
  The treatment was surgical, using complementary radiosurgery in just 1 patient. The type A infratemporal fossa approach was used in jugular paragangliomas, the approach was cervical in the carotid and vagal ones and, in the tympanics, a transmeatal or transmastoid approach was performed. In the 73 patients making up our study group, there were 11 recurrences which appeared in jugular paragangliomas (two of them in multiple PGL cases). The post-operative sequelae were mainly cranial nerve paralysis (VII, IX, X, XI, and XII), along with cerebrospinal fluid fistulas in 14 of the jugular PGLs.
  
  
  CONCLUSIONS
  With this article we try to reflect our experience in the treatment of this type of tumour. Surgical treatment achieves excellent control of the disease with an acceptable morbidity in young or middle-aged patients. In order to diminish the probabilities of facial nerve paralysis in jugular PGL we must avoid the facial nerve transposition in the infratemporal approach.
authors: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España. maritina79@hotmail.com
authors: María Agustina
authors: MA
authors: Sevilla García
authors: José Luis
authors: JL
authors: Llorente Pendás
authors: Juan Pablo
authors: JP
authors: Rodrigo Tapia
authors: Ginesa
authors: G
authors: García Rostán
authors: Vanesa
authors: V
authors: Suárez Fente
authors: Andrés
authors: A
authors: Coca Pelaz
authors: Carlos
authors: C
authors: Suárez Nieto
mesh_terms: D016022:Case-Control Studies; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D010235:Paraganglioma / Q000473:pathology* / Q000601:surgery; D016634:Radiosurgery / Q000379:methods; D012189:Retrospective Studies