title: Juxtacondylar approach in temporal paraganglioma surgery: when and why?
abstract: As it became clear that patients with paraganglioma (PGL) syndromes had a higher risk of multifocal tumors, we changed our surgical strategy to avoid the possibility of bilateral cranial nerve paralysis. The juxtacondylar approach offers advantages for some jugular foramen tumors, including types C and D temporal PGLs. This approach allows exposure of the jugular foramen without skeletonizing or transposing the facial nerve. It improves the surgeon's ability to distinguish between the pars vascularis and the pars nervosa at the jugular foramen, and it helps to save functioning of the lower cranial nerves. There is already considerable experience using the juxtacondylar approach for patients suffering from schwannomas and meningiomas involving the jugular foramen. Some limitations have been noted for using the juxtacondylar approach with jugular PGLs that are related to their vascular nature. In this article we demonstrate its use for the management of eight patients with locally advanced temporal PGLs and how it can be combined with an infratemporal fossa approach.
authors: Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Freiburg, Germany.
authors: Joerg
authors: J
authors: Schipper
authors: Uwe
authors: U
authors: Spetzger
authors: Marcos
authors: M
authors: Tatagiba
authors: Steffen
authors: S
authors: Rosahl
authors: Hartmut P H
authors: HP
authors: Neumann
authors: Carsten Christof
authors: CC
authors: Boedeker
authors: Wolfgang
authors: W
authors: Maier