Paragangliomas of the Head & Neck

The KMC experience

Sampath Chandra Prasad, Nikhil Thada, Pallavi, Kishore Chandra Prasad

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

To determine the clinical features, investigations, intra-operative findings, surgical approaches used and the results of the treatment for paragangliomas of the head and neck. Retrospective study of 14 cases of paragangliomas in head and neck seen over a period of 10 years including five carotid body tumors, seven glomus jugulares and two glomus tympanicums. HRCT scans and bilateral carotid angiography were done in all cases of glomus jugulare. Pre-operative embolization was done in most cases. The trans-cervical approach was used for all cases of carotid body. In three cases of Type B jugulare tumors, a post-aural tympanotomy was used. A Fisch Type A approach was done for three cases of Type D jugulare tumors. Postaural tympanotomy approach was used for both patients with glomus tympanicum. In one case of extratympanic glomus jugulare tumor with hypoglossal palsy, a neck exploration was done to isolate and excise the tumor. Five patients with carotid body tumors presented as unilateral, painless, pulsatile swelling in the upper neck. Intra-operatively, three of the tumors were classified into Shamlin's Grade II and one each into Grade III and Grade I. A carotid blow-out occurred in one of the patients with Grade II disease, which was managed. ECA resection had to be done in one case. Seven patients were diagnosed to have glomus jugulare and two with glomus tympanicum. Six glomus jugulare tumors presented with hearing loss, ear discharge and obvious swelling. Glomus tympanicums presented with hearing loss but no bleeding from the ear. On examination, tumors presented with an aural polyp with no VII nerve deficits. Both tympanicums were classified as Fisch Type A, three of the jugulares classified as Type B, two as Type D2 and one as Type D1. Tumors were found to be supplied predominantly by the ascending pharyngeal artery. In three cases of Type B jugulare tumors, a postaural tympanotomy was used. A Fisch Type A approach was done for three cases of Type D jugulare. The transcanal approach was used for both patients with glomus tympanicum. Paragangliomas are uncommon tumors that need accurate diagnosis and skilled operative techniques. Though the surgical approaches may appear complicated, the removal provides good cure rates with minimal morbidity and recurrence. Lateral skull base approaches should be the armamentarium of every head and neck surgeon.

Original languageEnglish
Pages (from-to)62-73
Number of pages12
JournalIndian Journal of Otolaryngology and Head and Neck Surgery
Volume63
Issue number1
DOIs
Publication statusPublished - 01-01-2011
Externally publishedYes

Fingerprint

Paraganglioma
Neck
Head
Glomus Tympanicum
Ear
Glomus Jugulare
Neoplasms
Glomus Jugulare Tumor
Carotid Body Tumor
Hearing Loss
Carotid Body
Skull Base
Facial Nerve
Polyps
Paralysis
Angiography
Retrospective Studies
Arteries
Hemorrhage
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

Cite this

Prasad, Sampath Chandra ; Thada, Nikhil ; Pallavi ; Prasad, Kishore Chandra. / Paragangliomas of the Head & Neck : The KMC experience. In: Indian Journal of Otolaryngology and Head and Neck Surgery. 2011 ; Vol. 63, No. 1. pp. 62-73.
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Paragangliomas of the Head & Neck : The KMC experience. / Prasad, Sampath Chandra; Thada, Nikhil; Pallavi; Prasad, Kishore Chandra.

In: Indian Journal of Otolaryngology and Head and Neck Surgery, Vol. 63, No. 1, 01.01.2011, p. 62-73.

Research output: Contribution to journalArticle

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