Comparison of Surgical Outcomes Between Early and Advanced Class of Jugular Paragangliomas Following Application of Our Modified Surgical Techniques

Overview

Journal Sci Rep

Specialty Science

Date 2023 Jan 17

PMID 36650202

Authors

Peng Zhao

Yibo Zhang

Feng Lin

Dedi Kong

Yisi Feng

Chunfu Dai

Affiliations

Soon will be listed here.

Abstract

To compare the safety and effectiveness of surgical treatment of jugular paragangliomas (JPs) following the application of our modified surgical techniques. Fifty-six patients with JPs were analyzed for tumor classification, surgical outcomes, and intratumor blood vessels. The gross total resection in C1-2 (100%) was significantly greater than that in C3 and D (66.7%). Good postoperative facial nerve (FN) function (House-Brackmann I-II) was achieved in 89.5% C1-2 cases, which was not significantly different from C3 and D (93.3%) (P = 0.694). Preoperative and postoperative lower cranial nerve (LCN) deficits correlated with the Fisch's classification of tumors (P < 0.05), and intraoperative blood loss was greater in advanced tumors (P = 0.050). Further study showed that the cross-sectional area of intratumor blood vessels was positively associated with intraoperative blood loss (P < 0.001). Surgical excision of JPs is a safe and effective strategy, and early surgical treatment is a good option for patients with C1-2 tumors without surgical contraindications.

Citing Articles

The intrabulbar or extrabulbar growth pattern and its surgical outcomes of jugular foramen paragangliomas.

Sun W, Zhang Y, Li W, Li F, Feng Y, Wu Q Eur Arch Otorhinolaryngol. 2024; 281(10):5233-5241.

PMID: 38977468 DOI: 10.1007/s00405-024-08769-9.

References

House J, Brackmann D . Facial nerve grading system. Otolaryngol Head Neck Surg. 1985; 93(2):146-7. DOI: 10.1177/019459988509300202. View

Ahmad R, Sivalingam S, Konishi M, De Donato G, Sanna M . Oncologic outcome in surgical management of jugular paraganglioma and factors influencing outcomes. Head Neck. 2012; 35(4):527-34. DOI: 10.1002/hed.22987. View

Prasad S, Mimoune H, Khardaly M, Piazza P, Russo A, Sanna M . Strategies and long-term outcomes in the surgical management of tympanojugular paragangliomas. Head Neck. 2015; 38(6):871-85. DOI: 10.1002/hed.24177. View

Grinblat G, Sanna M, Piccirillo E, Piras G, Guidi M, Shochat I . Comparison of Lower Cranial Nerve Function Between Tympanojugular Paraganglioma Class C1/C2 With and Without Intracranial Extension: A Four-Decade Experience. Otol Neurotol. 2021; 43(1):e122-e130. DOI: 10.1097/MAO.0000000000003383. View

Jansen T, Kaanders J, Beute G, Timmers H, Marres H, Kunst H . Surgery, radiotherapy or a combined modality for jugulotympanic paraganglioma of Fisch class C and D. Clin Otolaryngol. 2018; 43(6):1566-1572. DOI: 10.1111/coa.13216. View

Ivan M, Sughrue M, Clark A, Kane A, Aranda D, Barani I . A meta-analysis of tumor control rates and treatment-related morbidity for patients with glomus jugulare tumors. J Neurosurg. 2010; 114(5):1299-305. DOI: 10.3171/2010.9.JNS10699. View

Harati A, Deitmer T, Rohde S, Ranft A, Weber W, Schultheiss R . Microsurgical treatment of large and giant tympanojugular paragangliomas. Surg Neurol Int. 2015; 5:179. PMC: 4287915. DOI: 10.4103/2152-7806.146833. View

Jang M, Liu H, Dai C . The Application of Sigmoid Sinus Tunnel-packing or Push-packing of the Inferior Petrous Sinus in the Microsurgical Management of Jugular Paragangliomas. Otol Neurotol. 2018; 39(2):e166-e172. DOI: 10.1097/MAO.0000000000001683. View

Al-Mefty O, Teixeira A . Complex tumors of the glomus jugulare: criteria, treatment, and outcome. J Neurosurg. 2003; 97(6):1356-66. DOI: 10.3171/jns.2002.97.6.1356. View

10.

Wanna G, Sweeney A, Haynes D, Carlson M . Contemporary management of jugular paragangliomas. Otolaryngol Clin North Am. 2015; 48(2):331-41. DOI: 10.1016/j.otc.2014.12.007. View

11.

Forbes J, Brock A, Ghiassi M, Thompson R, Haynes D, Tsai B . Jugulotympanic paragangliomas: 75 years of evolution in understanding. Neurosurg Focus. 2012; 33(2):E13. DOI: 10.3171/2012.6.FOCUS12138. View

12.

Manzoor N, Yancey K, Aulino J, Sherry A, Khattab M, Cmelak A . Contemporary Management of Jugular Paragangliomas With Neural Preservation. Otolaryngol Head Neck Surg. 2020; 164(2):391-398. DOI: 10.1177/0194599820938660. View

13.

Sanna M, Shin S, Piazza P, Pasanisi E, Vitullo F, Di Lella F . Infratemporal fossa approach type a with transcondylar-transtubercular extension for Fisch type C2 to C4 tympanojugular paragangliomas. Head Neck. 2013; 36(11):1581-8. DOI: 10.1002/hed.23480. View

14.

Patel A, Rodriguez-Lopez J, Hirsch B, Burton S, Flickinger J, Clump D . Long term outcomes with linear accelerator stereotactic radiosurgery for treatment of jugulotympanic paragangliomas. Head Neck. 2020; 43(2):449-455. DOI: 10.1002/hed.26497. View

15.

Jansen T, Timmers H, Marres H, Kunst H . Feasibility of a wait-and-scan period as initial management strategy for head and neck paraganglioma. Head Neck. 2017; 39(10):2088-2094. DOI: 10.1002/hed.24871. View

16.

Patnaik U, Prasad S, Medina M, Al-Qahtani M, DOrazio F, Falcioni M . Long term surgical and hearing outcomes in the management of tympanomastoid paragangliomas. Am J Otolaryngol. 2015; 36(3):382-9. DOI: 10.1016/j.amjoto.2015.01.006. View

17.

Jansen T, Timmers H, Marres H, Kaanders J, Kunst H . Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class. Clin Otolaryngol. 2017; 43(2):652-661. DOI: 10.1111/coa.13046. View

18.

Gottfried O, Liu J, Couldwell W . Comparison of radiosurgery and conventional surgery for the treatment of glomus jugulare tumors. Neurosurg Focus. 2004; 17(2):E4. DOI: 10.3171/foc.2004.17.2.4. View

19.

Kong D, Zhang Y, Li F, Li W, Dai C . Tension-Free Anterior Rerouting of the Facial Nerve in Management of Jugular Foramen Paragangliomas. Laryngoscope. 2021; 131(12):2684-2687. DOI: 10.1002/lary.29658. View

20.

van den Berg R, Verbist B, Mertens B, van der Mey A, van Buchem M . Head and neck paragangliomas: improved tumor detection using contrast-enhanced 3D time-of-flight MR angiography as compared with fat-suppressed MR imaging techniques. AJNR Am J Neuroradiol. 2004; 25(5):863-70. PMC: 7974496. View