Head and Neck Paragangliomas: 10 years institutional experience

Background: Paragangliomas originate from neuroectodermal derived cells. They are very slow growing tumors. Patients usually present with a neck mass or hearing loss and tinnitus in jugulotympanic paragangliomas. In advanced stage cranial nerve palsies are more common. Radiographic studies are important for diagnosis and depending on location and stage of tumor, either surgery alone or post-operative radiation therapy is the mainstay of treatment. Material & Methods: It was a retrospective review of case records of patients treated at Aga Khan University Hospital, Karachi from October 2000 to October 2010. Results: Total number of patients was 24; 15 males and 9 females. Average age was 52.3 years. Fourteen (58.34%) were carotid body tumors, 5(20.83%) glomus tympanicum, 3(12.53%) glomus jugulare and 2(8.33%) were glomus vagale. CT scan was done in all patients to confirm the diagnosis and extent of tumor. Preoperative angiography and angioembolization was done in all patients. All patients underwent surgical resection. Complete resection was possible in all except in two cases of glomus jugulare. Recurrence was only in 2 cases of glomus tympanicum. Post-operatively, cranial nerve dysfunction was noted only in glomus vagale, where vagus nerve was scarified in both patients. Conclusion: Surgery has promising outcome in carotid body tumors but in jugulotympanic paragangliomas complete resection is challenging. In glomus vagale, surgery is always associated with vagus nerve palsy.