Management of bilateral head and neck paragangliomas at a single‐institution across four decades

Abstract

BackgroundBilateral head and neck paragangliomas (HNPGLs) require nuanced management to balance tumor control with functional preservation.MethodsAll patients seen at a single‐institution for bilateral paraganglioma between 1983 and 2023 were retrospectively reviewed. Demographics, genetic testing results, and tumor characteristics were analyzed and compared to treatment modality and cranial nerve outcomes.ResultsThere were 49 patients with 116 tumors (90 carotid body tumors [CBTs], 15 vagal paragangliomas [VPs], and 11 jugular paragangliomas [JPs]). Twenty‐six patients had SDH pathologic variants (PV). Surgical management was more commonly utilized in younger patients (OR: 0.97, 95% CI: 0.950–0.992) and for JPs (OR: 9, 95% CI: 1.386–58.443). In surgical cases, CBTs had a lower risk of postoperative cranial nerve deficits compared to JPs and VPs (OR: 0.095, 95% CI: 0.013–0.692).ConclusionsYounger patients with bilateral HNPGLs, especially those with JP and CBT, are more often treated with surgery. CBTs have lowest risk of cranial nerve deficits after surgery.