Paraganglioma of the Temporal Bone: Role of Magnetic Resonance Imaging versus Computed Tomography

Noujaim, Samir; Pattekar, Mandar A.; Cacciarelli, Alexander; Sanders, William P.; Wang, Ay-Ming

doi:10.1097/00002142-200004000-00006

Cited by 45 publications

(18 citation statements)

References 14 publications

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“…On CT scan, glomus tympanicum appears as a soft tissue mass abutting the promontory of the middle ear [6]. There may be displacement of ossicles or bony erosion of the tympanic cavity.…”

Section: Discussionmentioning

confidence: 99%

Glomus Tympanicum

Singh

Badhwar

D’Souza

et al. 2004

Medical Journal Armed Forces India

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“…On CT scan, glomus tympanicum appears as a soft tissue mass abutting the promontory of the middle ear [6]. There may be displacement of ossicles or bony erosion of the tympanic cavity.…”

Section: Discussionmentioning

confidence: 99%

Glomus Tympanicum

Singh

Badhwar

D’Souza

et al. 2004

Medical Journal Armed Forces India

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“…Tympanic paragangliomas can cause a pulsatile tinnitus due to the transmitting pulsations to the tympanic membrane by the hypervascular tumor in up to 82% of patients [25] A conductive hearing loss (56%) is caused because of interference or destruction of the ossicular chain [23,26]. Smaller tympanic paragangliomas do not destruct the surrounding bony structures.…”

Section: Clinical Presentation Tumor Characteristics and Specific Vamentioning

confidence: 99%

Imaging and management of head and neck paragangliomas

2005

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Paragangliomas of the head and neck are highly vascular lesions originating from paraganglionic tissue located at the carotid bifurcation (carotid body tumors), along the vagus nerve (vagal paragangliomas), and in the jugular fossa and tympanic cavity (jugulotympanic paragangliomas). Diagnostic imaging can be considered in two clinical situations: (1) patients who present with clinical symptoms suggestive of a paraganglioma, and (2) individuals from families with hereditary paragangliomas. It is not only necessary to detect and characterize the lesion, but also to study the presence of multiplicity. For these purposes, MR imaging, and especially 3D TOF MRA, is the modality of choice. CT scanning is especially useful to show destruction of the temporal bone. Angiography in combination with embolization will mainly be used prior to surgical resection, but can also be used for diagnostic purposes when the diagnosis is not yet clear. Many parameters play a role in the decision to treat of which multifocality and impairment of cranial nerves are the most important. The primary therapeutic option for paragangliomas is complete excision of tumor with preservation of vital neurovascular structures. Resection however, should be balanced against a more conservative "wait and scan" policy or palliative treatments such as radiotherapy.

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“…VP are contiguous with the vagus nerve, lie 1-2 cm below the jugular foramen and frequently displace the lateral pharyngeal wall medially and the ICA anteromedially, whereas CBT centered in the carotid bifurcation may compress the vagus nerve and splay the external carotid artery and ICA [Arts and Fagan, 1991;Borba and Al-Mefty, 1996;Endicott and Maniglia, 1980;Noujaim et al, 2000]. Large VP may extend caudally towards the carotid bifurcation or cephalad into the jugular foramen [Harnsberger, 2004].…”

Section: Discussionmentioning

confidence: 99%

Management of Vagal Paragangliomas Including Application of Internal Carotid Artery Stenting

et al. 2011

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Background: The primary treatment of vagal paraganglioma (VP) includes ‘wait and scan’, surgery and radiotherapy. Objectives: To present the clinical findings, surgical treatment including application of internal carotid artery (ICA) stenting to facilitate surgery, and complications, as well as to review the literature and to discuss the decision-making process in the management of VP cases based on our experience and the literature. Design: A retrospective case review of 22 cases with VP. Setting: Quaternary neurotologic and skull base referral center. Material and Methods: The retrospective chart review identified 22 patients presenting with VP. Our indication for surgery was VP in younger patients, irrespective of the existence of vocal cord paralysis. Preoperative endovascular management of the ICA included permanent balloon occlusion (PBO) and stenting. The transcervical approach and the infratemporal fossa approach type A (ITFA) were used. Results: Fifteen cases had multicentric paragangliomas, 5 cases bilateral tumors, 3 cases a genetic mutation, and 2 cases a positive family history. The most common symptoms were hoarseness, tinnitus and hearing loss. The surgical approaches commonly employed for excision were the transcervical approach (9 cases) and the ITFA (12 cases), whereas 1 case did not have surgery. Three cases had PBO and 7 had intracarotid stent insertion. Gross total removal was achieved in 19 cases, and 1 case had a recurrence. Eighteen cases had no dysphagia or were well compensated after surgery. There were no significant complications noted in our series. Conclusions: In younger patients with VP, surgery should be recommended. The proper preoperative endovascular intervention and surgical approach facilitates gross total tumor removal. In the management of bilateral or familial paragangliomas, careful and appropriate decision making is essential.

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Paraganglioma of the Temporal Bone: Role of Magnetic Resonance Imaging versus Computed Tomography

Cited by 45 publications

References 14 publications

Glomus Tympanicum

Glomus Tympanicum

Imaging and management of head and neck paragangliomas

Management of Vagal Paragangliomas Including Application of Internal Carotid Artery Stenting

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