title: Head and Neck Paragangliomas: An Update on Evaluation and Management.
abstract: OBJECTIVE
  Head and neck paragangliomas are a group of slow-growing hypervascular tumors associated with the paraganglion system. The approach to evaluate and treat these lesions has evolved over the last 2 decades. While radical surgery had been the traditional approach, improvements in diagnostic imaging as well as radiation therapy techniques have led to an emphasis on observation and nonsurgical therapy in many patients. This article reviews the contemporary approach to the workup and management of head and neck paragangliomas.
  
  
  METHODS
  Articles were identified from PubMed.
  
  
  METHODS
  PubMed searches with the following keywords were performed: carotid body paraganglioma management, vagal paraganglioma management, jugulotympanic paraganglioma management, imaging of head and neck paragangliomas, head and neck paraganglioma embolization, paraganglioma radiation, head and neck paraganglioma management, observation of head and neck paragangliomas, bilateral carotid body paragangliomas, and genetics of paragangliomas. Review and original research articles available in the English language and published during or after 2009 were selected on the basis of their clinical relevance and scientific strength. Certain articles published prior to 2009 were also included if they provided background information that was relevant.
  
  
  CONCLUSIONS
  Workup and treatment of head and neck paragangliomas are changing. With more now known regarding the longitudinal behavior of these tumors, observation and nonsurgical therapy are indicated in many instances. For patients where surgery is the most appropriate option, improved diagnostic and perioperative techniques are allowing patients to tolerate resection, often with reduced morbidity.
authors: Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA mgmoore@gmail.com.
authors: Michael G
authors: MG
authors: Moore
authors: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors: James L
authors: JL
authors: Netterville
authors: Department of Radiation Oncology, University of Florida School of Medicine, Gainesville, Florida, USA.
authors: William M
authors: WM
authors: Mendenhall
authors: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors: Brandon
authors: B
authors: Isaacson
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Brian
authors: B
authors: Nussenbaum
mesh_terms: D003952:Diagnostic Imaging; D019468:Disease Management; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D010235:Paraganglioma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*
keywords: carotid body paraganglioma; jugulare paraganglioma; paraganglioma; vagal paraganglioma