Pathophysiology of sensorineural hearing loss in jugular foramen paraganglioma

Isaacson, Brandon; Wick, Cameron C.; Perez, Carlos L.; Cantrell, Sarah C.; Killeen, Daniel E.

doi:10.1002/lary.27343

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…As reported before, TJP patients characteristically show a combined hearing loss [ 14 , 22 , 23 ]. Comparing the functional results according to the audiology findings, there was no relevant difference between the conventional and laser surgery group after retroauricular and infratemporal fossa type A approach.…”

Section: Discussionmentioning

confidence: 91%

Surgical management of tympanojugular paragangliomas using the flexible CO2 laser

Hackenberg

Meyer

Häfner

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose Surgery is a standard therapy for tympanojugular paragangliomas (TJP). Maintaining the quality of life (QoL) requires functional preservation. The flexible CO2 laser allows contact-free tumor removal. This retrospective study compares the postoperative functional outcomes of TJP surgery with and without the flexible CO2 laser. Methods Between 2005 and 2019, 51 patients with TJP were surgically treated at a tertiary hospital. Until 2012, 17 patients received conventional surgery. Thereafter, the flexible laser was used in 34 patients. Tumor extend, pre- and postoperative cranial nerve function, and complications were compared between the groups. Results The cohort consisted of 33 class A and B tumors and 18 class C and D tumors. Preoperative embolization was performed in 17 cases. Class C/D TJP were usually removed via an infratemporal fossa type A approach. Gross total tumor removal was achieved in 14/18 class C/D tumors. 3/51 patients suffered from long-term partial or complete facial palsy. No differences in post-therapeutic cranial nerve function or complications were noted between the conventional and laser group. One recurrence was observed after complete tumor resection. Conclusion The flexible CO2 laser was shown to be a safe and effective alternative to conventional bipolar cauterization, which is appreciated by the surgeon in these highly vascularized tumors. Both techniques allowed a high tumor control rate and good long-term results also from a functional point of view.

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Section: Discussionmentioning

confidence: 91%

Surgical management of tympanojugular paragangliomas using the flexible CO2 laser

Hackenberg

Meyer

Häfner

et al. 2022

Eur Arch Otorhinolaryngol

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“…Given that the JF region is in close proximity to the middle ear cavity, structural anomalies or lesions arising in close proximity to this region may consequently contribute to the development of PT. 18 This study demonstrated a comprehensive analysis of associated structural abnormalities or lesions surrounding the JF region in patients with PT, which may be beneficial for appreciation of the clinico-radiological characteristics and potentially aid in decision-making for patients with PT.…”

Section: Discussionmentioning

confidence: 99%

“…28 Although PT can be present as one of the symptoms in patients with JF tumors, it rarely emerged as the first or major symptom. 18…”

Section: Discussionmentioning

confidence: 99%

“…28 Although PT can be present as one of the symptoms in patients with JF tumors, it rarely emerged as the first or major symptom. 18 Due to the close proximity with the middle ear, tumors arising from the JF region and internal acoustic meatus may also contribute to the development of PT. 2 However, in accordance with previous reports, these tumors were rarely detected in patients included in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical Variations of the Jugular Foramen Region in Patients with Pulsatile Tinnitus

Yang

et al. 2021

J Neurol Surg B Skull Base

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Objective Structural anomalies of the jugular foramen (JF) and adjacent structures may contribute to development of pulsatile tinnitus (PT). The goal of this study was to assess anatomical variants in the ipsilateral JF region in patients with PT and to explore possible predisposing factors for PT. Materials and Methods One hundred ninety-five patients with PT who underwent CT angiography and venography of the temporal bone were retrospectively analyzed. Anatomic variants including dominance of the ipsilateral JF, bony deficiency of the sigmoid sinus and internal carotid artery canal, high riding or dehiscent jugular bulb, dehiscence of the superior semicircular canal, tumors in the JF region, or cerebellopontine angle were assessed. Results Of 195 patients with PT, the prevalence of a dominant JF on the ipsilateral side of patients with PT was 67.2%. Furthermore, the dominant JF demonstrated a significant correlation with the presence of ipsilateral PT (p < 0.001). No anatomical variants were present in 22 patients (11.3%), whereas in patients with structural variants, bony deficiency of the sigmoid sinus was most common (65.6%), followed by high riding (54.9%) or dehiscent jugular bulb (14.4%). Dehiscent internal carotid artery canal (3.1%) and superior semicircular canal (4.1%) were occasionally identified, while arteriovenous fistula, arterial aneurysm and tumors arising from the JF region or cerebellopontine angle were rarely encountered. Conclusion Structural abnormalities of the JF and adjacent structures may predispose to the development of PT. Knowledge of these anatomical variants in the JF region may help establish a clinical strategy for addressing PT.

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“…Another hypothesis may involve changes to local vasculature as a result of these lesions. Isaacson et al (9) have proposed occlusion of the inferior cochlear vein as a pathophysiologic mechanism for sensorineural hearing loss in jugular foramen paragangliomas that did not show cochlear invasion or direct eighth nerve involvement.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Transcanal and Transmastoid Laser-Assisted Resection of Middle Ear Capillary Hemangioma

Patel¹,

Deep²,

Liu

et al. 2021

Otology &Amp; Neurotology

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Objective: To present a rare case of a middle ear capillary hemangioma in an adult. Patient: A 31-year-old woman with a 6-month history of left ear fullness, pressure, tinnitus, and progressive hearing loss. Intervention: Endoscopic laser-assisted resection. Main Outcome Measures: Clinical, radiographic, and histopathological findings of a capillary hemangioma. Results: Otoscopy revealed an erythematous and slightly pulsating multilobulated middle ear retrotympanic mass. Her audiogram demonstrated a left-sided mixed hearing loss with air-conduction thresholds in the severe-to-profound range. Computed tomography (CT) imaging was significant for total opacification of the left middle ear and mastoid air cells. She underwent a combined endoscopic transcanal and transmastoid excision of the mass with ossicular chain reconstruction.

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Pathophysiology of sensorineural hearing loss in jugular foramen paraganglioma

Abstract: 4 Laryngoscope, 2018.

Cited by 5 publications

References 23 publications

Surgical management of tympanojugular paragangliomas using the flexible CO2 laser

Surgical management of tympanojugular paragangliomas using the flexible CO2 laser

Anatomical Variations of the Jugular Foramen Region in Patients with Pulsatile Tinnitus

Endoscopic Transcanal and Transmastoid Laser-Assisted Resection of Middle Ear Capillary Hemangioma

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