In this article, the authors stress three fundamental points in the diagnostic and therapeutic angiographic study of tympano-jugular glomus tumours. The first basic concept is the need for complete right, left, internal carotid, vertebral and external carotid angiographic examination. The latter must be selective, regardless of the information provided by common carotid arteriography. This implies prior knowledge of the different arteries which may "supply" the gloumus tumour. The second basic point is the concept of vascular compartment, , often mutually independent and vascularised by a single pedicle. The juxtaposition of the different vascular compartments gives the exact size of the tumour. The third important point concerns embolisation carried out at the same time as diagnostic angiography. This is invariably indicated on a pre-operative basis, except in two circumstances: --when the glomus, tumour is small and situated close to the drum of the tympanum, its surgical excision posing no problem of haemostasis under these circumstances: --when radiotherapy is envisaged as treatment of the glomus tumour when surgery is impossible. In this case, embolisation is contraindicated for two reasons: -radiotherapy is more effective when blood flow is preserved; -the risks of necrosis are increased.
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Cureus
April 2024
Radiation Oncology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.
Paragangliomas are sympathetic and parasympathetic para-ganglia neuroendocrine tumors of the autonomic nervous system. We analyzed a bifocal paraganglioma case of a 52-year-old patient in December 2013 with hearing loss and right ear pain, headaches, episodes of vomiting, and abdominal pain ten months before her medical consultation. The diagnosis of a right tympano-jugular glomus paraganglioma was based on cerebral magnetic resonance imaging and treated with radiotherapy.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
March 2016
Otolaryngology, University Hospital, Padua, Italy.
The objective of this study was to assess the value of a limited tumor excision in tympano-jugular paragangliomas treated with observation with the goal of preventing, or repairing, a neural (VII cranial nerve) or brain damage and continue an otherwise correct observation. This is a retrospective case review. Each patient was submitted to a complete neuro-radiological work-up for diagnosis including CT, MRI, and angiography if needed of tympano-jugular paraganglioma class C.
View Article and Find Full Text PDFLaryngoscope
February 2012
Department of Sensory Organs, Sapienza University of Rome, Rome, Italy.
Objectives/hypothesis: Facial synkinesis and hyperkinesis commonly impair the outcome of facial nerve palsy. Botulinum toxin type A has shown positive results in the treatment of these symptoms. Our experience is reported in this article.
View Article and Find Full Text PDFArch Mal Coeur Vaiss
October 2007
Service de chirurgie vasculaire, CHU hôpital Ibn Sina, Rabat, Morocco.
The multiple paragangliomas are rare tumours, with slow evolution, posing diagnostic and therapeutic problems. The carotid and jugulo-tympanic localization are the most frequent, and the aortic localization is very infrequent. The association of two, three and four localization is possible in the multiple forms.
View Article and Find Full Text PDFOtolaryngol Clin North Am
August 2006
Gruppo Otologico, via Emmanueli 42, 29100, Piacenza, Italy.
The infratemporal fossa approach type A is the best way to deal with recurrent tympano-jugular paragangliomas because facial nerve rerouting is fundamental to reaching the area of the internal carotid artery, where recurrence is likely to occur. Preservation of lower cranial nerve function is not feasible when there is tumor infiltration of the medial wall of the jugular bulb; any attempt at nerve dissection increases the risk of leaving some tumor remnants. Correct management of the internal carotid artery, including preoperative stent insertion or permanent preoperative balloon occlusion, is usually a fundamental step when dealing with these highly vascularized lesions.
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