Jugular paraganglioma treatment at the UMC Maribor
Background: Jugular paragangliomas are rare, almost exclusively benign and slowly growing tumors. Arising from the cells of paraganglia in jugular bulb, they infiltrate the temporal bone and later grow intracranially. Because of insidious onset, their diagnosis is relatively late. Patients at presen...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Slovenian Medical Association
2017-11-01
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| Series: | Zdravniški Vestnik |
| Subjects: | |
| Online Access: | http://vestnik.szd.si/index.php/ZdravVest/article/view/2491 |
| _version_ | 1819169503460720640 |
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| author | Janez Rebol Boštjan Lanišnik Janez Ravnik Marko Jevšek Miha Ložar |
| author_facet | Janez Rebol Boštjan Lanišnik Janez Ravnik Marko Jevšek Miha Ložar |
| author_sort | Janez Rebol |
| collection | DOAJ |
| description | Background: Jugular paragangliomas are rare, almost exclusively benign and slowly growing tumors. Arising from the cells of paraganglia in jugular bulb, they infiltrate the temporal bone and later grow intracranially. Because of insidious onset, their diagnosis is relatively late. Patients at presentation usually complain of pulsatile tinnitus and hearing loss, lasting for years. Also common are palsies of the cranial nerves in the area of tumor growth – i.e., facial, glossopharyngeal, vagal, accessory and hypoglossal nerves. Surgical resection is the standard treatment, though technically demanding because of difficult approach to the lateral cranial base and vital structures in the area. The team for treating such patients comprises an ENT specialist, interventional radiologist and a neurosurgeon. The purpose of this article is to review clinical experiences with the treatment of jugular paragangliomas at our Department of ENT and Maxillofacial Surgery of the University Medical Centre Maribor.
Methods: We reviewed the documentation of ten patients treated for jugular paraganglioma in the last 15 years, and presented the clinical data in a table.
Results: Nine patients were treated by preoperative embolization and surgical resection. Surgery was contraindicated in one patient with highly dominant venous drainage on the side of the tumor and aplastic transverse sinus on the opposite side. She was treated by primary radiotherapy. One patient with intracranial tumor growth was treated by subtotal resection and adjuvant radiotherapy. At presentation, lower cranial nerve palsies were present in 60 % of our patients. With the other 40 % we managed to preserve the nerve function postoperatively. Facial nerve function practically normalized in all patients with anterior transposition of the nerve. Our patients were provided with postoperative rehabilitation and corrective procedures such as vocal cord medialization and BAHA hearing aid implantation.
Discussion: Despite the risks, the surgical treatment is effective in halting the disease and preserving cranial nerve function. The results of our work demonstrate that our patients are provided with a thorough and comprehensive care. |
| first_indexed | 2024-12-22T19:20:32Z |
| format | Article |
| id | doaj.art-2d58eaec35254809992fde8423f4b143 |
| institution | Directory Open Access Journal |
| issn | 1318-0347 1581-0224 |
| language | English |
| last_indexed | 2024-12-22T19:20:32Z |
| publishDate | 2017-11-01 |
| publisher | Slovenian Medical Association |
| record_format | Article |
| series | Zdravniški Vestnik |
| spelling | doaj.art-2d58eaec35254809992fde8423f4b1432022-12-21T18:15:24ZengSlovenian Medical AssociationZdravniški Vestnik1318-03471581-02242017-11-01869-1010.6016/slovmedjour.v86i9-10.24912064Jugular paraganglioma treatment at the UMC MariborJanez Rebol0Boštjan Lanišnik1Janez Ravnik2Marko Jevšek3Miha Ložar4Oddelek za otorinolaringologijo in maksilofacialno kirurgijo, Univerzitetni klinični center MariborOddelek za otorinolaringologijo in maksilofacialno kirurgijo, Univerzitetni klinični center MariborOddelek za nevrokirurgijo, UKC MariborOddelek za radiologijo, UKC MariborOddelek za otorinolaringologijo in maksilofacialno kirurgijo, Univerzitetni klinični center MariborBackground: Jugular paragangliomas are rare, almost exclusively benign and slowly growing tumors. Arising from the cells of paraganglia in jugular bulb, they infiltrate the temporal bone and later grow intracranially. Because of insidious onset, their diagnosis is relatively late. Patients at presentation usually complain of pulsatile tinnitus and hearing loss, lasting for years. Also common are palsies of the cranial nerves in the area of tumor growth – i.e., facial, glossopharyngeal, vagal, accessory and hypoglossal nerves. Surgical resection is the standard treatment, though technically demanding because of difficult approach to the lateral cranial base and vital structures in the area. The team for treating such patients comprises an ENT specialist, interventional radiologist and a neurosurgeon. The purpose of this article is to review clinical experiences with the treatment of jugular paragangliomas at our Department of ENT and Maxillofacial Surgery of the University Medical Centre Maribor. Methods: We reviewed the documentation of ten patients treated for jugular paraganglioma in the last 15 years, and presented the clinical data in a table. Results: Nine patients were treated by preoperative embolization and surgical resection. Surgery was contraindicated in one patient with highly dominant venous drainage on the side of the tumor and aplastic transverse sinus on the opposite side. She was treated by primary radiotherapy. One patient with intracranial tumor growth was treated by subtotal resection and adjuvant radiotherapy. At presentation, lower cranial nerve palsies were present in 60 % of our patients. With the other 40 % we managed to preserve the nerve function postoperatively. Facial nerve function practically normalized in all patients with anterior transposition of the nerve. Our patients were provided with postoperative rehabilitation and corrective procedures such as vocal cord medialization and BAHA hearing aid implantation. Discussion: Despite the risks, the surgical treatment is effective in halting the disease and preserving cranial nerve function. The results of our work demonstrate that our patients are provided with a thorough and comprehensive care.http://vestnik.szd.si/index.php/ZdravVest/article/view/2491tumorglomus jugularekirurgijaembolizacija |
| spellingShingle | Janez Rebol Boštjan Lanišnik Janez Ravnik Marko Jevšek Miha Ložar Jugular paraganglioma treatment at the UMC Maribor Zdravniški Vestnik tumor glomus jugulare kirurgija embolizacija |
| title | Jugular paraganglioma treatment at the UMC Maribor |
| title_full | Jugular paraganglioma treatment at the UMC Maribor |
| title_fullStr | Jugular paraganglioma treatment at the UMC Maribor |
| title_full_unstemmed | Jugular paraganglioma treatment at the UMC Maribor |
| title_short | Jugular paraganglioma treatment at the UMC Maribor |
| title_sort | jugular paraganglioma treatment at the umc maribor |
| topic | tumor glomus jugulare kirurgija embolizacija |
| url | http://vestnik.szd.si/index.php/ZdravVest/article/view/2491 |
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