Radiologic approach to paragangliomas of the temporal bone

High-resolution computed tomography (HRCT) has become the primary radiologic method for evaluation of paragangliomas of the temporal bone. The HRCT evaluation of the integrity of certain bony landmarks has a profound effect on selection of surgical approach. The most important landmarks are the bony walls separating the carotid artery and the jugular bulb from the middle ear. Arteriography is not necessary if the lesion is confined to the middle ear. However, it is indicated in tumors that have eroded the above landmarks or in those patients with related neurologic symptoms.