Treatment of Head and Neck Paragangliomas

Hu, Kenneth; Persky, Mark S.

doi:10.1177/107327481602300306

Cited by 65 publications

(93 citation statements)

References 90 publications

(139 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions of the head and neck. 17 Herein, we provide a report of our institutional experience with 194 patients with HNPGLs from 2000-2017, with an emphasis on our approach to clinical evaluation, treatment, and genetic investigation of CBP, JP, VP, TP, SCP, and multi-focal HNPGL patient cohorts. Finally, we posit an evidence-based algorithm for multidisciplinary clinical evaluation and management of these diverse neoplasms.…”

Section: Introductionmentioning

confidence: 99%

Head and neck paragangliomas: A two‐decade institutional experience and algorithm for management

Smith

Harvey

Darr

et al. 2017

Laryngoscope Investig Oto

View full text Add to dashboard Cite

ObjectivesParagangliomas of the head and neck and cranial base are typically benign, slow‐growing tumors arising within the jugular foramen, middle ear, carotid bifurcation, or vagus nerve proper. The objective of this study was to provide a comprehensive characterization of our institutional experience with clinical management of these tumors and posit an algorithm for diagnostic evaluation and treatment.MethodsThis was a retrospective cohort study of patients undergoing treatment for paragangliomas of the head and neck and cranial base at our institution from 2000–2017. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic work‐up, pre‐treatment cranial nerve palsy, treatment modality, utilization of preoperative angiographic embolization, complications of treatment, tumor control and recurrence, and hereditary status (ie, succinate dehydrogenase mutations) were collected and summarized.ResultsThe mean (SD) age of our cohort was 51.8 (±16.1) years with 123 (63.4%) female patients and 71 (36.6%) male patients. Catecholamine‐secreting lesions were found in nine (4.6%) patients. Fifty‐one patients underwent genetic testing, with mutations identified in 43 (20 SDHD, 13 SDHB, 7 SDHD, 1 SDHA, SDHAF2, and NF1). Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were variably employed as treatment approaches across anatomic subsites.ConclusionAn algorithmic approach to clinical management of these tumors, derived from our longitudinal institutional experience and current empiric evidence, may assist otolaryngologists, radiation oncologists, and geneticists in the care of these complex neoplasms.Level of Evidence4

show abstract

Section: Introductionmentioning

confidence: 99%

Head and neck paragangliomas: A two‐decade institutional experience and algorithm for management

Smith

Harvey

Darr

et al. 2017

Laryngoscope Investig Oto

View full text Add to dashboard Cite

show abstract

“…Presence of excessive cathecolamine release should be investigated during preoperative period using urinary metanephrine, and vanillylmandelic acid measurements. During surgery for functional tumors, alpha-adrenergic blocker drugs should be at hand so as to prevent hypertensive episodes due to excessive cathecolamine discharge [15]. Preoperative cathecolamine levels of all of our patients were within normal limits.…”

Section: Discussionmentioning

confidence: 92%

Anesthetic considerations for carotid body tumors surgery

Kavakli

Öztürk

2016

North Clin Istanbul

View full text Add to dashboard Cite

OBJECTIVE:Carotid body tumors (CBT) are benign tumors that originate from neural non-chromaffin cells that are typically localized near carotid bifurcation. Surgical removal of the tumor is the most appropriate treatment. General anesthesia is preferred anesthetic technique for CBT surgery. Basic elements of anesthetic management are protection of hemodynamic stability and maintaining cerebral perfusion pressure (CPP). The aim of this study was to evaluate anesthetic management of CBT surgery and present the literature knowledge.METHODS:The study included 10 consecutive patients with diagnosis of CBT who underwent surgery at Antalya Training and Research Hospital, in Antalya, Turkey, between 2013 and 2016. Preoperative demographic details; comorbidities; side of surgical site; duration of operation; length of intensive care unit (ICU) and hospital stay; change of intraoperative blood pressure; use of inotropic drugs, blood products, and analgesics; postoperative visual analogue scale (VAS) pain score; and complications were recorded.RESULTS:According to Shamblin classification, 3 tumors were type I and the remaining 7 were type II. Tumors were located on right side in 6 patients, and on left in 4. Blood loss sufficient to require transfusion was observed in 1 patient. Average intraoperative blood loss was 287±68 mL. Tachycardia and hypertension were observed in 1 patient; bradycardia and hypotension were seen in 4 patients. Infusion for inotropic support was administered to 1 patient. Mean duration of operation was 109±20 minutes. Mean VAS score was 4±1, mean ICU tramadol consumption was 80±25 mg. Duration of stay in ICU and hospital were 2.4±1.1 hours and 3.8±0.7 days, respectively. Mortality and neurological complications were not seen in postoperative period.CONCLUSION:CBT surgery requires close and complex anesthesia management. Protection of hemodynamic stability against sudden hemodynamic changes, monitoring, and maintaining CPP are the most important aspects of anesthetic management.

show abstract

“…Kenneth described post-operative complications like vascular Injury, baroreflex failure and Cranial Nerve Injury 16 .Andersons series of the thirteen definitive cases, one patient had Iigation of the carotid artery prior toexcision of the tumor 17 . This is what was followed in our case.…”

Section: Discussionmentioning

confidence: 99%

Carotid body Tumour with Hypoglossal Nerve Palsy- A Case Report

Haroon¹,

Taher²,

Alam³

et al. 2019

Bangladesh Heart J

View full text Add to dashboard Cite

Objective: Carotid body tumour is a rare tumour. This is a case report of carotid body tumour of the right side involving the right hypoglossal nerve with MRI appearance and pathological features. The objective is to present a case of Hypoglossal nerve palsy due to carotid body tumour involving the right carotid artery bifurcation. Method: A 18-year old male presented with a welldefined swelling of his right neck, increasing hoarseness, and left ward tongue deviation on protrusion present for two years CT neck and MRI were done. The tumour was identified and the patient underwent surgery. His Histopathology report commented it to be carotid body tumour. Result: The patient showed significant improvement after surgery. His tongue deviation improved and his hoarseness of voice had been begun to improve. Conclusion: Carotid body tumours are benign lesion mimicking other pathology. High level of suspicision, imaging and careful resection is important for avoiding complications. Bangladesh Heart Journal 2019; 34(1) : 68-72

show abstract

Treatment of Head and Neck Paragangliomas

Cited by 65 publications

References 90 publications

Head and neck paragangliomas: A two‐decade institutional experience and algorithm for management

Head and neck paragangliomas: A two‐decade institutional experience and algorithm for management

Anesthetic considerations for carotid body tumors surgery

Carotid body Tumour with Hypoglossal Nerve Palsy- A Case Report

Contact Info

Product

Resources

About