Temporal bone paragangliomas: Egas Moniz Hospital experience
DOI:
https://doi.org/10.34631/sporl.877Keywords:
paraganglioma, temporal bone, infratemporal fossa, facial nerveAbstract
Objectives: To report our experience in the diagnostic, therapeutic decision and follow-up of patients with temporal bone paragangliomas.
Methods: Retrospective study of 28 patients with temporal bone paragangliomas who were treated at our department between 2011 and 2019. The clinical records were analyzed and data related to symptoms, physical examination, imaging tests, surgical procedures and response regarding the various therapeutic modalities were collected.
Results: Nineteen patients (67.86%) presented with a Class C tumor, 8 (28.57%) with a Class B tumor and 1 (3.57%) with a Class A tumor. Nine (32, 14%) had intracranial extension (Class D). Surgical removal was the initial treatment in 24 patients (85.71%), wait-and-scan in 3 (10.71%) and radiotherapy in 1 (3.57%). All tympanojugular paragangliomas underwent pre-operative tumor embolization. In 86.96% a gross-total tumor removal was achieved and 3 among them (15%) developed a recurrence.
Conclusions: This is one of the largest Portuguese series. Analyzed outcomes are similar to published international series.
References
- Sanna M, Piazza P, Shin SH, Flanagan S. et al. Microsurgery of Skull Base Paragangliomas. Suttgart: Thieme; 2013. 690 p. Available from: https://www.thieme.com/books-main/neurosurgery/product/1525-microsurgery-of-skull-base-paragangliomas
- Prasad SC, Paties CT, Schiavi F, Esposito DL, et al. Tympanojugular Paragangliomas: Surgical Management and Clinicopathological Features. In: Mariani-Costantini R, editors. Paragangliomas: A Multidisciplinary Approach. Brisbane: Codon Publications; 2019. Chapter 6. Available from: https://exonpublications.com/index.php/exon/article/view/15
- Lee JH, Barich F, Karnell LH, Robinson RA, et al. National Cancer Data Base report on malignant paragangliomas of the head and neck. Cancer. 2002 Feb 1;94(3):730-7. doi: 10.1002/cncr.10252.
- Sivalingam S, Shin SH, Lella FD, Lauda L, et al. Tympanojugular Paragangliomas. In: Kirtane MV, Souza CE, editors. Otology and Neurotology. Suttgart: Thieme; 2013. Chapter 34. Available from: https://www.thieme.com/books-main/otolaryngology/product/1970-otology-and-neurotology
- D’Almeida GN, Escada P, Branco G, Vital JP. Paragangliomas jugulo-timpânicos. Técnica cirúrgica e experiência do Hospital de Egas Moniz. Revista Portuguesa De Otorrinolaringologia E Cirurgia De Cabeça E Pescoço. 2009 Mar; 47(1):26-33. doi: 10.34631/sporl.34
- Oldring D, Fisch U. Glomus tumors of the temporal region: surgical therapy. Am J Otol. 1979 Jul; 1(1):7-18.
- Sanna M, Fois P, Pasanisi E, Russo A. et al. Middle ear and mastoid glomus tumors (glomus tympanicum): an algorithm for the surgical management. Auris Nasus Larynx. 2010 Dec; 37(6):661-8. doi: 10.1016/j.anl.2010.03.006
- Prasad SC, Mimoune HA, Khardaly M, Piazza P. et al. Strategies and Long-Term Outcomes in the Surgical Management of Tympanojugular Paraganglioma. Head Neck. 2016 Jun;38(6):871-85. doi: 10.1002/hed.24177.
- Srirangalingam U, LeCain M, Tufton N, Akker SA. et al. Four generations of SDHB-related disease: complexities in management. Fam Cancer. 2017 Apr;16(2):279-282. DOI: 10.1007/s10689-016-9946-9.
- Donato S, Simões H, Pinto AT, Cavaco MB. et al. SDHx-related pheochromocytoma/paraganglioma - genetic, clinical, and treatment outcomes in a series of 30 patients from a single center. Endocrine. 2019 Aug; 65(2):408-415. doi: 10.1007/s12020-019-01953-6.
- Jackson CG. Glomus tympanicum and glomus jugulare tumors. Otolaryngol Clin North Am. 2001 Oct; 34(5):941-70, vii. doi: 10.1016/s0030-6665(05)70356-x.
- Erickson D, Kudva YC, Ebersold MJ, Thompson GB. et al. Benign paragangliomas: clinical presentation and treatment outcomes in 236 patients. J Clin Endocrinol Metab. 2001 Nov; 86(11):5210-6. doi: 10.1210/jcem.86.11.8034.
- Contrera KJ, Yong V, Reddy CA, Liu SW. et al. Recurrence and Progression of Head and Neck Paragangliomas after Treatment. Otolaryngol Head Neck Surg. 2020 Apr; 162(4):504-511. doi: 10.1177/0194599820902702.
- Skrivan J, Zverina E, Kluh J, Chovanec M. et al. Our experience with surgical treatment of tympanojugular pragangliomas. Prague Med Rep. 2010;111(1):25-34.
Pareschi R, Righini S, Destito D, Raucci AF. et al. Surgery of glomus jugulare tumors. Skull Base. 2003 Aug; 13(3):149-157. doi: 10.1055/s-2003-43325.
- Makiese O, Chibbaro S, Marsella M, Tran Ba Huy P. et al. Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases. Neurosurg Rev. 2012 Apr; 35(2):185-94; discussion 194. doi: 10.1007/s10143-011-0346-1.
- Moe KS, Li D, Linder TE, Schmid S. et al. An update on the surgical treatment of temporal bone paraganglioma. Skull Base Surg. 1999; 9(3):185-94. doi: 10.1055/s-2008-1058145.
- Borba LA, Ale-Bark S, London C. Surgical treatment of glomus jugulare tumors without rerouting of the facial nerve: an infralabyrinthine approach. Neurosurg Focus. 2004 Aug 15; 17(2):E8. doi: 10.3171/foc.2004.17.2.8.
- Sanna M, Shin SH, Piazza P, Pasanisi E. et al. Infratemporal fossa approach type a with transcondylar-transtubercular extension for Fisch type C2 to C4 tympanojugular paragangliomas. Head Neck. 2014 Nov; 36(11):1581-8. doi: 10.1002/hed.23480
- Sanna M, Flanagan S. The combined transmastoid retro- and infralabyrinthine transjugular transcondylar transtubercular high cervical approach for resection of glomus jugulare tumors. Neurosurgery. 2007 Dec; 61(6):E1340; author reply E1340. doi: 10.1227/01.neu.0000306136.66849.5c.
- Sanna M, Khrais T, Menozi R, Piaza P. Surgical removal of jugular paragangliomas after stenting of the intratemporal internal carotid artery: a preliminary report. Laryngoscope. 2006 May; 116(5):742-6. doi: 10.1097/01.mlg.0000205199.61105.cb.
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