Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery
Introduction: The treatment of glomus jugulare tumors can be extremely challenging. In certain patients, residual tumor is left at surgery to prevent devastating lower cranial nerve deficits or to reduce potential morbidity associated with carotid artery injury. The interest of this article is to de...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-03-01
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| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751918300446 |
| _version_ | 1819144505601818624 |
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| author | Lotfi Boublata, MD, PhD Sofiane Ouhab, MD, PhD |
| author_facet | Lotfi Boublata, MD, PhD Sofiane Ouhab, MD, PhD |
| author_sort | Lotfi Boublata, MD, PhD |
| collection | DOAJ |
| description | Introduction: The treatment of glomus jugulare tumors can be extremely challenging. In certain patients, residual tumor is left at surgery to prevent devastating lower cranial nerve deficits or to reduce potential morbidity associated with carotid artery injury. The interest of this article is to demonstrate the importance of anterior transposition of the facial nerve in the approach of the jugular paraganglioma and to analyze the surgical technique, complications, and outcomes. Methods: We retrospectively studied 07 patients with jugular paragangliomas treated between January 2010 and December 2016 at Ali Ait Idir University Hospital in Algiers, Algeria. All patients were operated by the infratemporal fossa approaches type A (Fisch) [13]. We have developed for better exposed jugular golf the anterior transposition of the facial nerve. Preoperative embolization was performed for all patients. Results: Total removal was possible in 04 patients. The most frequent and also the most dangerous surgical complication was lower cranial nerve deficit. This deficit occurred in 02 patients, but it was transient in one cases. Cerebrospinal fluid leakage remains a potentially fatal complication. In our study two patients developed CSF leaks and were treated conservatively with iterative lumbar punctures. Transposition of a normal facial nerve usually causes moderate postoperative paresis that may improve partially within 3 to 6 months. Conclusion: Radical resection of jugular paragangliomas is difficult, and infratemporale approach (Fisch type A) with anterior transposition of facial nerve offer the best chance of total removal with preservation of facial and lower cranial nerves. |
| first_indexed | 2024-12-22T12:43:12Z |
| format | Article |
| id | doaj.art-ba0c47d1775e4be0b4fa4eef4e21a0ee |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-22T12:43:12Z |
| publishDate | 2019-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-ba0c47d1775e4be0b4fa4eef4e21a0ee2022-12-21T18:25:23ZengElsevierInterdisciplinary Neurosurgery2214-75192019-03-0115106112Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgeryLotfi Boublata, MD, PhD0Sofiane Ouhab, MD, PhD1Algiers Medical School, Ali Ait Idir Neurosurgery Specialized Institution Algiers, Algeria; Corresponding author.Algiers Medical School, Bachir Mantouri University Hospital Algiers, AlgeriaIntroduction: The treatment of glomus jugulare tumors can be extremely challenging. In certain patients, residual tumor is left at surgery to prevent devastating lower cranial nerve deficits or to reduce potential morbidity associated with carotid artery injury. The interest of this article is to demonstrate the importance of anterior transposition of the facial nerve in the approach of the jugular paraganglioma and to analyze the surgical technique, complications, and outcomes. Methods: We retrospectively studied 07 patients with jugular paragangliomas treated between January 2010 and December 2016 at Ali Ait Idir University Hospital in Algiers, Algeria. All patients were operated by the infratemporal fossa approaches type A (Fisch) [13]. We have developed for better exposed jugular golf the anterior transposition of the facial nerve. Preoperative embolization was performed for all patients. Results: Total removal was possible in 04 patients. The most frequent and also the most dangerous surgical complication was lower cranial nerve deficit. This deficit occurred in 02 patients, but it was transient in one cases. Cerebrospinal fluid leakage remains a potentially fatal complication. In our study two patients developed CSF leaks and were treated conservatively with iterative lumbar punctures. Transposition of a normal facial nerve usually causes moderate postoperative paresis that may improve partially within 3 to 6 months. Conclusion: Radical resection of jugular paragangliomas is difficult, and infratemporale approach (Fisch type A) with anterior transposition of facial nerve offer the best chance of total removal with preservation of facial and lower cranial nerves.http://www.sciencedirect.com/science/article/pii/S2214751918300446 |
| spellingShingle | Lotfi Boublata, MD, PhD Sofiane Ouhab, MD, PhD Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery Interdisciplinary Neurosurgery |
| title | Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery |
| title_full | Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery |
| title_fullStr | Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery |
| title_full_unstemmed | Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery |
| title_short | Infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery |
| title_sort | infratemporal approach with anterior transposition of facial nerve in paraganglioma surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2214751918300446 |
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