JUGULAR FORAMEN PARAGANGLIOMA (GLOMUS JUGULARE): A 10-YEAR SINGLE-CENTER EXPERIENCE.

Abstract

Jugulotympanic paragangliomas (JTPs) are rare, hypervascular skull base tumors. Surgery and stereotactic radiosurgery (SRS) are often framed as competing options, yet outcome data from Latin American public referral centers are scarce. We evaluated a function-first surgical strategy and related tumor stage to outcomes. Retrospective single-center study of 24 consecutive patients with histopathologically confirmed JTP who underwent 32 resections (2016-2025), analyzed at patient and procedure level. Fisch class (A/B vs. C/D) was related to extent of resection, cranial nerve morbidity, and reoperation (Fisher's exact test, exploratory). Functional outcome (modified Rankin Scale) was assessed at 6 and 12 months; cranial nerve deficits were classified as transient or permanent. Mean age was 51 years; 83% were women. Advanced (Fisch C/D) tumors comprised 79%. Preoperative embolization was used in 88%. Gross total resection was achieved in 56% of procedures. New or worsened facial nerve injury occurred after 25% of procedures (permanent in 6 of 8 affected patients), and all facial injuries occurred in Fisch C/D tumors. Eight patients (33%) required unplanned reoperation; none were planned staged. There was no perioperative mortality. Functional outcome was favorable (median modified Rankin Scale score 1 at 12 months; mRS ≤2 in 92%). After a median follow-up of 86 months, recurrence after gross total resection occurred in 4 patients and progression of residual disease in 2. In a predominantly advanced, public-referral cohort, a function-first surgical strategy with SRS reserved for residual or recurrent disease achieved good functional outcomes without mortality. Surgery and SRS are complementary rather than competing modalities.