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Balancing Surgery and Radiosurgery in Jugulotympanic Paragangliomas.

Giorgos Sideris1, Evangelos Panagoulis1, Ilias Lazarou1

  • 12nd ENT Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.

Cureus
|August 11, 2025
PubMed
Summary

Jugulotympanic paragangliomas (JTPs) are rare tumors. Surgical resection is preferred for small JTPs, while a combination of surgery and stereotactic radiosurgery (RS) is crucial for complex cases and tumor control.

Keywords:
glomus jugulareglomus tumorglomus tympanicumstereotactic radiosurgerysurgical excision

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Area of Science:

  • Neuroscience
  • Oncology
  • Otolaryngology

Background:

  • Jugulotympanic paragangliomas (JTPs) are rare, locally aggressive neuroendocrine tumors.
  • Their location near critical neurovascular structures causes significant morbidity.

Purpose of the Study:

  • To retrospectively assess treatment outcomes for JTPs.
  • To evaluate the effectiveness of surgical resection and stereotactic radiosurgery (RS) for tumor control and recurrence prevention.

Main Methods:

  • Retrospective analysis of 11 adult JTP patients (2022-2024).
  • Data included demographics, tumor characteristics (Fisch classification), surgical approach, and follow-up imaging.
  • Ki-67 index assessed proliferative activity.

Main Results:

  • Eleven patients (7 female, 4 male; median age 64.5) were analyzed.
  • Tumor sizes varied; Fisch classifications included A, B, C1, and D1.
  • Complete resection in 5 cases, 6 required additional RS; no recurrence in resected cases, tumor control with RS.
  • Most tumors had Ki-67 < 5%; this index did not predict recurrence.

Conclusions:

  • Surgical resection is the primary treatment for small, accessible JTPs.
  • Combined surgery and RS are vital for glomus jugulare, residual, or complex JTPs.
  • Ki-67 index is not an independent predictor of JTP recurrence.