Sclerotic Head and Neck Paragangliomas: An Unfavorable Indicator Associated With Surgical Outcomes.

Abstract

This retrospective case-control study investigated surgical outcomes of head and neck paragangliomas (HNPGLs) with varying degrees of sclerosis. Data from 95 patients who underwent HNPGL surgery over 20 years were analyzed. Based on histology, tumors were classified as having non-significant (< 30%) or significant (≥ 30%) sclerosis. Seventy patients had non-significant sclerosis and 25 had significant sclerosis. The significant sclerosis group was younger (39 vs. 44 years, p = 0.026), had more multiple tumors (48% vs. 12.9%, p = 0.001), higher nerve injury rates (p = 0.021), and more vascular injuries (20.8% vs. 4.17%, p = 0.022). Multivariate analysis identified tumor volume (OR = 1.014, p = 0.005) and sclerosis degree (OR = 0.276, p = 0.013) as independent risk factors for severe complications involving both nerve and vascular injury. Sclerotic HNPGLs are associated with earlier onset, multiple tumors, and increased risk of intraoperative complications, suggesting unfavorable surgical outcomes.