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Multi-Disciplinary Approach to Skull Base Paragangliomas
Steven D Curry1,2, Armine Kocharyan1,2, Gregory P Lekovic1,3
1House Clinic, Los Angeles, CA 90017, USA.
Brain Sciences
|November 25, 2023
Summary
Surgery plays a vital role in managing skull base paragangliomas, even when CyberKnife stereotactic radiosurgery (SRS) is used for tumor control. Combined surgical and SRS approaches achieve excellent outcomes and preserve cranial nerve function.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Otolaryngology
Background:
- Skull base paragangliomas require nuanced treatment strategies.
- Cranial nerve preservation is increasingly prioritized.
- Balancing tumor control with functional outcomes is crucial.
Purpose of the Study:
- To evaluate the role of surgery in skull base paraganglioma patients treated with CyberKnife stereotactic radiosurgery (SRS).
- To assess the efficacy of combined surgical and SRS management for definitive tumor control.
Main Methods:
- Retrospective review of 22 patients treated with SRS between 2010-2022.
- Analysis of surgical interventions (gross total vs. partial/subtotal resection) preceding or concurrent with SRS.
- Review of clinical and imaging follow-up data.
Main Results:
- Fourteen patients (63.6%) underwent microsurgical resection.
- Gross total resection was achieved in 4 patients; partial/subtotal resection in 10.
- All 18 patients with follow-up demonstrated clinical and radiological tumor control post-SRS, with no mortalities.
Conclusions:
- Surgery remains an integral part of multidisciplinary skull base paraganglioma treatment.
- Combined surgical and SRS approaches achieve excellent tumor control and functional preservation.
- Tailoring surgical resection based on tumor characteristics and patient symptoms is essential.
