ZusammenfassungParagangliome im Kopf-Hals-Bereich sind seltene Tumoren und treten sowohl sporadisch als auch hereditär auf. Sie können Systemerkrankungen darstellen und sollten interdisziplinär abgeklärt werden. Nach internistischen, radiologischen und genetischen Gesichtspunkten lassen sich Niedrig-/und Hochrisikopatienten identifizieren. Klinische Herausforderungen sind eine mögliche Metastasierung, multilokuläre Manifestationen und Rezidive. Hereditäre Paragangliome können im Rahmen einer Disposition zusammen mit weiteren Tumorerkrankungen auftreten. Der vorliegende Artikel soll relevante Aspekte zu Paragangliomen der A. carotis zusammenfassen und einen praktikablen Algorithmus zu Diagnostik, Therapie und Nachsorge liefern.
To analyze the association of tumor volume with outcome after surgery for cervical paraganglioma. Materials and Methods: This retrospective study included consecutive patients undergoing surgery for cervical paraganglioma from 2009–2020. Outcomes were 30-day morbidity, mortality, cranial nerve injury, and stroke. Preoperative CT/MRI was used for tumor volumetry. An association between the volume and the outcomes was explored in univariate and multivariable analyses. A receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated. The study was conducted and reported according to the STROBE statement. Results: Volumetry was successful in 37/47 (78.8%) of included patients. A 30-day morbidity occurred in 13/47 (27.6%) patients with no mortality. Fifteen cranial nerve lesions occurred in eleven patients. The mean tumor volume was 6.92 cm3 in patients without and 15.89 cm3 in patients with complications (p = 0.035) and 7.64 cm3 in patients without and 16.28 cm3 in patients with cranial nerve injury (p = 0.05). Neither the volume nor Shamblin grade was significantly associated with complications on multivariable analysis. The AUC was 0.691, indicating a poor to fair performance of volumetry in predicting postoperative complications. Conclusions: Surgery for cervical paraganglioma bears a relevant morbidity with a particular risk of cranial nerve lesions. Tumor volume is associated with morbidity, and MRI/CT volumetry can be used for risk stratification.
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