Clinical Presentation and Management of Jugular Foramen Paraganglioma

다국어 초록 (Multilingual Abstract)

Objectives. Jugular foramen paraganglioma is a locally invasive, benign tumor, which grow slowly and causes various symptoms
such as pulsatile tinnitus and low cranial nerve palsy. Complete surgical resection is regarded as the ideal management
of these tumors. The goal of this study is to identify the clinical characteristics and most effective surgical
approach for jugular foramen paraganglioma.
Methods. Retrospective analysis of 9 jugular foramen paraganglioma patients who underwent surgical resection between
1986 and 2005 was performed. Clinical records were reviewed for analysis of initial clinical symptoms and signs,
audiological examinations, neurological deficits, radiological features, surgical approaches, extent of resection, treatment
outcomes and complications.
Results. Most common initial symptom was hoarseness, followed by pulsatile tinnitus. Seven out of 9 patients had at least
one low cranial nerve palsy. Seven patients were classified as Fisch Type C tumor and remaining 2 as Fisch Type
D tumor on radiologic examination. Total of 11 operations took place in 9 patients. Total resection was achieved
in 6 cases, when partial resection was done in 3 cases. Two patients with partial resection received gamma knife radiosurgery
(GKS), when remaining 1 case received both GKS and two times of revision operation. No mortality was
encountered and there were few postoperative complications.
Conclusion. Neurologic examination of low cranial nerve palsy is crucial since most patients had at least one low cranial
nerve palsy. All tumors were detected in advanced stage due to slow growing nature and lack of symptom. Angiography
with embolization is crucial for successful tumor removal without massive bleeding. Infratemporal fossa approach
can be considered as a safe, satisfactory approach for removal of jugular foramen paragangliomas. In tumors with
intracranial extension, combined approach is recommended in that it provides better surgical view and can maintain
the compliance of the patients.

다국어 초록 (Multilingual Abstract)

Objectives. Jugular foramen paraganglioma is a locally invasive, benign tumor, which grow slowly and causes various symptoms
such as pulsatile tinnitus and low cranial nerve palsy. Complete surgical resection is regarded as the ideal management
of these tumors. The goal of this study is to identify the clinical characteristics and most effective surgical
approach for jugular foramen paraganglioma.
Methods. Retrospective analysis of 9 jugular foramen paraganglioma patients who underwent surgical resection between
1986 and 2005 was performed. Clinical records were reviewed for analysis of initial clinical symptoms and signs,
audiological examinations, neurological deficits, radiological features, surgical approaches, extent of resection, treatment
outcomes and complications.
Results. Most common initial symptom was hoarseness, followed by pulsatile tinnitus. Seven out of 9 patients had at least
one low cranial nerve palsy. Seven patients were classified as Fisch Type C tumor and remaining 2 as Fisch Type
D tumor on radiologic examination. Total of 11 operations took place in 9 patients. Total resection was achieved
in 6 cases, when partial resection was done in 3 cases. Two patients with partial resection received gamma knife radiosurgery
(GKS), when remaining 1 case received both GKS and two times of revision operation. No mortality was
encountered and there were few postoperative complications.
Conclusion. Neurologic examination of low cranial nerve palsy is crucial since most patients had at least one low cranial
nerve palsy. All tumors were detected in advanced stage due to slow growing nature and lack of symptom. Angiography
with embolization is crucial for successful tumor removal without massive bleeding. Infratemporal fossa approach
can be considered as a safe, satisfactory approach for removal of jugular foramen paragangliomas. In tumors with
intracranial extension, combined approach is recommended in that it provides better surgical view and can maintain
the compliance of the patients.

참고문헌 (Reference)

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