Vertebral Artery Involvement by Tympanojugular Paragangliomas: Management and Outcomes with a Proposed Addition to the Fisch Classification

Vertebral Artery Involvement by Tympanojugular Paragangliomas: Management and Outcomes with a Proposed Addition to the Fisch Classification

Seung-Ho Shin, Shailendra Sivalingam, Giuseppe De Donato, Maurizio Falcioni, Paolo Piazza and Mario Sanna

Abstract
Objective: To present the management and outcomes of cases of tympanojugular paraganglioma (TJP) with vertebral artery (VA) involvement, and to propose the addition of the new ‘V’ category to the Fisch classification.

Conclusion: Although uncommon, the intradural or extradural VA can be involved by TJP. To avoid vascular accidents, the VA should be thoroughly evaluated at the planning stage. We advocate that the addition of a ‘V’ category would help to identify patients who need individualized VA management as part of a complete surgical evaluation.