Management of Complex Tympanojugular Paragangliomas Including Endovascular Intervention

Management of Complex Tympanojugular Paragangliomas Including Endovascular Intervention

Mario Sanna, Seung-Ho Shin, Giuseppe De Donato, Shailendra Sivalingam, Lorenzo Lauda, Francesca Vitullo and Paolo Piazza

Abstract
Objective: To identify complex cases of tympanojugular paraganglioma (TJP) and to analyze their management and surgical outcome. To present strategy and guidelines on how to deal with the perioperative complicating factors.

Conclusion: It is essential to carefully investigate the hemodynamics of the brain in planning surgery. A proper preoperative endovascular intervention facilitates gross total tumor removal. In bilateral paragangliomas, lower cranial nerves’ function should be preserved at least unilaterally. Staged removal is recommended for a tumor with a large intradural component.