[The jugulotympanic paragangliomas: 41 cases report]

Area of Science:

• Otolaryngology
• Neurosurgery
• Oncology

Background:

• Jugulotympanic paragangliomas (JTP) are the most common middle ear and temporal bone tumors after acoustic neurinoma.
• The optimal management strategy for these vascular tumors remains unclear.
• This study reports institutional experience with JTP management.

Purpose of the Study:

• To evaluate the effectiveness and outcomes of different therapeutic approaches for jugulotympanic paragangliomas.
• To compare surgical, radiotherapeutic, and combined treatment modalities for JTP.
• To inform clinical decision-making for JTP management.

Main Methods:

• Retrospective analysis of 41 patients with JTP treated between 1973 and 1996.
• Classification of tumors based on Fisch staging, with 49% exhibiting intracranial extension.
• Patients were grouped by primary treatment: surgery, radiation therapy, or surgery followed by radiation therapy.

Main Results:

• Surgical tumor removal achieved >95% success with no recurrence at 6-year follow-up, but significant morbidity (cranial nerve injury) was noted.
• Radiotherapy in 75% of cases led to tumor stabilization (5-year follow-up) but posed a risk of radionecrosis.
• One death occurred due to laryngospasm post-surgery.

Conclusions:

• Radical surgery is encouraged for JTP when feasible due to high success rates.
• Radiotherapy is indicated for elderly patients, those at surgical risk, or with extensive tumors, aiming for stabilization.
• Multidisciplinary management and genetic screening for familial cases are crucial for optimal JTP care.