Management of head and neck paragangliomas: review of 120 patients.

Abstract

Head and neck paragangliomas (PGL) are rare, mostly benign tumors. About 10% to 15% of PGL are caused by mutations in the succinate dehydrogenase genes B, C, or D and may appear multifocally. A retrospective review of 120 patients with 146 head and neck PGL, including 46 carotid body tumors (CBT), 13 vagal tumors, 55 jugulotympanic tumors (JTT), 25 tympanic tumors (TT) and 7 tumors in other locations are included. The internal carotid artery was preserved in 97.5% of CBT resections. Preservation of hearing was achieved in 92% of JTT and 88% of TT resections. According to our experience, the treatment of PGL must be individualized, taking into account the patient's age, medical condition, tumor site and size, multiple occurrences, and preexisting cranial nerve deficits. Tumor control is high whether treatment is by surgery or radiotherapy. Patients with solitary lesions whose disease is potentially resectable with acceptable morbidity are better treated surgically.