title: [Head and neck paragangliomas: An interdisciplinary challenge].
abstract: BACKGROUND
  Current treatment strategies for head and neck paragangliomas are moving away from radical resection and toward surgical tumor reduction, in order to preserve function and reduce morbidity. Radiotherapy modalities are alternative primary treatment options.
  
  
  METHODS
  A PubMed search of the relevant literature on genetics and treatment of head and neck paragangliomas was conducted.
  
  
  RESULTS
  The rapid progress made in genetic research was mainly triggered by two factors: firstly, the establishment of central registries for paraganglioma patients and secondly, the availability of next-generation sequencing methods. Exome sequencing and a gene-panel sequencing approach have already been successfully applied to paraganglioma syndromes. The latter method in particular is rapid and cost-effective, and may soon replace complex genotyping algorithms. The literature provides good evidence that diversified modern treatment options are available to realize individual treatment concepts for almost all paraganglioma manifestations. Generally, small and symptomatic tumors should be completely resected, particularly in younger patients. Considering the patient's age, symptoms, morbidity risk, and comorbidities, larger tumors should be surgically treated in a function-preserving manner. In these cases, primary radiotherapy is an equivalent alternative option. A "wait and scan" strategy is possible in selected cases.
  
  
  CONCLUSIONS
  The potential morbidity of surgical treatment must be weighed against the expectable quality of life. Comprehensive consultation with the patient about possible treatment modalities is mandatory. Treatment decision making should involve a multidisciplinary team of experts.
authors.affiliation: Hals-Nasen-Ohren-Klinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland. julian.kuenzel@unimedizin-mainz.de.
authors.forename: J
authors.initials: J
authors.lastname: Künzel
authors.affiliation: Hals-Nasen-Ohren-Klinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Bahr
authors.affiliation: Institut für Pathologie, Universitätsmedizin Mainz, Mainz, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Hainz
authors.affiliation: Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsmedizin Mainz, Mainz, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Rossmann
authors.affiliation: Hals-Nasen-Ohren-Klinik, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Matthias
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D003131:Combined Modality Therapy / Q000379:methods; D019317:Evidence-Based Medicine; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005820:Genetic Testing / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy*; D006801:Humans; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010348:Patient Care Team / Q000458:organization & administration*; D011878:Radiotherapy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Function-preserving therapy; Paraganglioma; Skull base; Stereotactic radiosurgery; Succinate dehydrogenase