Management of Carotid Body Paragangliomas and Review of a 30-year Experience

Patetsios, Peter; Gable, Dennis; Garrett, Wilson V.; Lamont, Jeffrey P.; Kuhn, Joseph A.; Shutze, William P.; Kourlis, Harry; Grimsley, Bradley R.; Pearl, Gregory J.; Smith, Bertram L.; Talkington, C.M.; Thompson, Jesse E.

doi:10.1007/s10016-001-0106-8

Cited by 178 publications

(251 citation statements)

References 18 publications

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“…This may be attributed to adequate collateral circulation through circle of Willis. If the clamping period is less than 10 min, the risk of developing neurological damage is very low as per Patetsis et al [17]. Temporary balloon occlusion of the carotid artery to assess the adequacy of collateral circulation across the circle of Willis can be done at the time of carotid angiography [3].…”

Section: Discussionmentioning

confidence: 99%

Surgical Excision of Carotid Body Tumor Through Modified Approach–A Case Report

Prabakaran¹,

Subburayulu²,

Ravikumar

2015

J. Maxillofac. Oral Surg.

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Paragangliomas arising from the carotid body in the carotid bifurcation are termed as carotid body tumors. They are usually slow growing and asymptomatic. Considering the anatomical location, invasion or pressure on the adjacent vascular and neural tissues, the importance of early diagnosis and management is critical. In this article a case of carotid body tumor excised through transverse neck skin crease incision is presented along with literature review on the diagnosis, grading and different surgical approaches.

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Section: Discussionmentioning

confidence: 99%

Surgical Excision of Carotid Body Tumor Through Modified Approach–A Case Report

Prabakaran¹,

Subburayulu²,

Ravikumar

2015

J. Maxillofac. Oral Surg.

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“…As discussed by Patetsios et al in 2002 and Marzo et al in 1997 with regard to both functional and nonfunctional PGL of the head and neck, radiographic observation with or without the use of RT is the treatment mainstay for the elderly or severely infirm. 15,16 Embolization and long-term therapeutic use of α/β-blockers would seem to be a legitimate method of symptomatic treatment in nonsurgical candidates with functional PGL, but little evidence is available to support this strategy outside of preparation for surgical excision.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

J Neurol Surg Rep

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IntroductionParagangliomas (PGLs) are rare and highly vascular tumors of neural crest origin that comprise only 0.6% of all head and neck tumors. 1 Formerly known as glomus tumors, or chemodectomas, PGLs develop from the extraadrenal chromaffin and chief cells of autonomic paraganglia in various locations throughout the body, usually in association with the walls of blood vessels or specific nerves. 2,3 Although these generally benign lesions most often present by exerting local effects on surrounding structures, a smaller subset of tumors can retain their neuroendocrine functionality and present with signs and symptoms of excess circulating catecholamines. These hypersecretory or functional PGLs can further complicate treatment by requiring a significant amount of autonomic pharmacotherapy to decrease the hemodynamic risks associated with any physical manipulation of the tumor itself.Of the various reported locations for PGL to develop in the head and neck, the carotid body has been cited as the most common site, followed in order of frequency by the jugulotympanic region, vagal body, and less common sites like the larynx, pharynx, and ciliary ganglion. 1 The infratemporal fossa (ITF) represents an especially rare location for a PGL to emerge, with only a handful of cases in the literature describing such a presentation. 4,5 Given the complex anatomy of the anterior skull base and the critical neurovascular structures within the ITF, successful resection of such a highly vascular tumor within this space presents numerous perioperative and intraoperative challenges. This report describes the management of a rare hypersecretory PGL of the infratemporal fossa. Case ReportA 44-year-old white man was referred to the Head and Neck Surgery service for evaluation of a right skull base mass, after Keywords ► functional paraganglioma ► infratemporal fossa ► maxillary swing ► glomus tumor Abstract Background Paragangliomas are rare neural crest tumors that can manifest in the head and neck as either functional or more commonly as nonfunctional lesions. Paragangliomas of the infratemporal fossa are exceedingly rare, with no more than a handful of documented cases. Like other tumors of this space, surgical management is challenging on account of complex anatomy and nearby critical structures. Methods A 44-year-old man presented with a right infratemporal fossa functional paraganglioma. Following preemptive embolization and autonomic pharmacotherapy, his tumor was successfully resected via a transfacial maxillary swing approach. Results This case highlights the surgical management of a functional paraganglioma of the infratemporal fossa while demonstrating the effectiveness of a transfacial maxillary swing approach for both exposure and resection. Conclusion Although this report summarizes much of the literature on paragangliomas, there is still much to uncover regarding the fundamental features and genetic etiology of these lesions.

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“…При больших опухолях (IV тип) данное вмешательство сопряжено с высоким риском возникновения эмболических осложнений [12,14,19,20,22,25,28]. Ряд авторов [13,17,29,31,32,34,35] считают, что после эмболизации происходит асептическое воспаление адвентиции, в результате чего во время операции невозможно субадвентици-ально выделить артерии от опухоли и сохранить целостность артерии, поэтому они отказываются от проведения эмболиза-ции. В связи с этим в приведенных наблюдениях мы не выпол-няли предварительную эмболизацию сосудов, питающих опу-холь.…”

Section: Discussionunclassified