title: [Management of Complex Tympanojugular Paragangliomas].
abstract: Background:Tympanojugular paraganglioma (TJP) are benign, high vascularized, local destructive tumors. Despite many studies in the literature, the management of particularly complex TJP (e. g., posterior fossa and/or carotid artery invasion) remains controversial. In the current study we present our treatment strategies for complex TJP and long-term results.Patients and methods:Between 2003 and 2013, 17 patients with TJP Fisch types C and D were treated in our institution. Primary symptoms were hearing loss, followed by facial nerve palsy and lower cranial nerve impairments. 2 patients presented with recurrent tumors. Surgical treatment after endovascular tumor embolization was performed in 14 patients. 2 patients were treated by radiation therapy.Results:Gross tumor resection was achieved in 10 patients. A temporary postoperative facial nerve palsy occurred in 2 patients and permanent postoperative vocal cord palsy in 3 patients. During long term follow-up, one patient experienced regrowth of the residual tumor. No tumor progress was observed in both patients treated with radiation therapy. Outcome assessed by Karnofsky scale showed 100% functionality in 12 patients and 90% in 5 patients.Discussion:Surgical treatment of TJP after endovascular embolization is the treatment of choice in young and healthy patients. In older patients with premorbid conditions, radiation therapy is the main treatment option and is associated with high tumor control rates. Precise preoperative staging together with individualize risk-benefit assessment and interdisciplinary treatment strategy are essential for a favorable outcome.
authors.affiliation: Neurosurgical department, Klinikum Dortmund, Dortmund.
authors.forename: A
authors.initials: A
authors.lastname: Harati
authors.affiliation: Neurosurgical department, Klinikum Dortmund, Dortmund.
authors.forename: R
authors.initials: R
authors.lastname: Schultheiß
authors.affiliation: Department of Plastic Surgery, Bergmannsheil Bochum, Bochum.
authors.forename: K
authors.initials: K
authors.lastname: Harati
authors.affiliation: Department of Radiology, Klinikum Dortmund, Dortmund.
authors.forename: S
authors.initials: S
authors.lastname: Rohde
authors.affiliation: Department of Radiology, Knappschaftskrankenhaus Bochum-Langendreer, Bochum.
authors.forename: W
authors.initials: W
authors.lastname: Weber
authors.affiliation: HNO-Klinik, Klinikum Dortmund, Dortmund.
authors.forename: T
authors.initials: T
authors.lastname: Deitmer
mesh_terms: D004621:Embolization, Therapeutic; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010235:Paraganglioma / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome