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Related Experiment Video

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Glomus Vagale Tumor Resection: 2-Dimensional Operative Video.

Daniel M Heiferman1, Esther A Cheng2, Michael E Harkins3

  • 1Department of Neurological Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois.

Operative Neurosurgery (Hagerstown, Md.)
|October 7, 2020
PubMed
Summary

This study details the surgical removal of a large left paraganglioma in a 37-year-old female, addressing symptoms like hearing loss and facial paralysis. The complex resection involved combined approaches and cranial nerve monitoring, with a successful outcome.

Keywords:
Glomus vagale tumorsInfratemporal fossaJugular foramenParaganglioma

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Head and Neck Surgery

Background:

  • Paragangliomas are rare neuroendocrine tumors that can occur in the head and neck region.
  • Jugular foramen paragangliomas can present with diverse neurological symptoms due to their proximity to cranial nerves.

Observation:

  • A 37-year-old female presented with hearing loss, headaches, and transient facial paralysis.
  • Magnetic resonance imaging revealed a large left paraganglioma involving the jugular foramen.

Findings:

  • The tumor was surgically resected using a combined infratemporal fossa and transcervical approach with cranial nerve monitoring.
  • Resection involved complex dissection around the petrous carotid artery and cranial nerves IX, X, XI, and XII.
  • Postoperative findings included temporary weakness of cranial nerves and facial nerve palsy, with recovery within a week.

Implications:

  • This case highlights the challenges and multidisciplinary approach required for successful resection of large jugular foramen paragangliomas.
  • Careful surgical technique and cranial nerve monitoring are crucial for minimizing neurological deficits.
  • Long-term imaging is essential to monitor for residual tumor, as seen with the thin rim around the petrous carotid.