AI Article Synopsis
- - This study evaluated the effectiveness of surgical techniques in treating complex jugular paragangliomas, focusing on tumor control and preserving cranial nerve function in 12 patients treated between 2013 and 2020.
- - Out of the 12 patients, 75% achieved complete tumor removal, with a 100% tumor control rate during a follow-up averaging 45.5 months; 83.3% of patients maintained or improved their facial nerve function post-surgery.
- - The study suggests advanced surgical strategies, such as facial nerve rerouting and staged surgeries, to enhance patient outcomes and minimize risks of nerve damage, particularly in patients with bilateral paragangliomas.
Article Abstract
Background: This study aimed to review tumor control and cranial nerve function outcomes in patients with complex jugular paragangliomas and to refine the surgical strategies for complex jugular paragangliomas.
Methods: We describe our experience with 12 patients with complex jugular paragangliomas diagnosed in our institution from January 2013 to June 2020. The main outcomes included tumor control, complications, and function of facial nerve and lower cranial nerves, postoperatively.
Results: Gross-total resection was achieved for 9 (75%) patients, and subtotal resection was achieved for 3 (25%) patients. The surgical tumor control rate was 100% after a mean follow-up of 45.5 months (range, 13-111 months). Postoperatively, 10 patients (83.3%) obtained unchanged or improved facial nerve function. However, new lower cranial nerve deficits occurred in 2 patients (16.7%) due to surgical removal of the concurrent vagal paraganglioma and scar tissue enclosing the IX and XII nerves.
Conclusion: Our refined surgical techniques, including tension-free anterior facial nerve rerouting, sigmoid sinus tunnel-packing, and pushpacking techniques, could be a choice for the treatment of complex jugular paragangliomas to achieve tumor control and cranial nerves preservation. A 2-stage surgery should be applied to minimize the risk of bilateral cranial neuropathies and the influence on cerebral circulation in patients with bilateral paragangliomas. The preoperative endovascular intervention such as coil embolization or internal carotid artery stenting can be employed for the management of paragangliomas with internal carotid artery-associated lesions.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682854 | PMC |
| http://dx.doi.org/10.5152/iao.2022.22675 | DOI Listing |
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