Head and neck paragangliomas

Year 2008, Volume: 18 Issue: 6, 343 - 348, 20.12.2008

İmdat Yüce Sedat Çağlı Ali Bayram Ercihan Güney

Abstract

Objectives: We evaluated patients who were treated for head and neck paragangliomas. Patients and Methods: The study included 40 patients 25 females, 15 males; mean age 48 years; range 26 to 74 years who were operated on for paragangliomas of the head and neck region between 1993 and 2007. Clinical findings, treatment modalities, and the results of treatment were evaluated. Results: The most common complaint was neck swelling n=30 , followed by tinnitus n=7 , hearing loss n=6 , imbalance n=3 , pain n=2 , hoarseness n=2 , and nasal obstruction n=1 . The mean duration of symptoms was 22 months. The most common paraganglioma was glomus caroticum n=28 with a mean tumor diameter of 4.5 cm range 2 to 12 cm . Urinary vanilmandelic acid concentration was measured in 24 patients and found above normal range in two patients. Octreotide scintigraphy was performed in 14 patients and femoral angiography was performed in 27 patients. Multicentric disease was present in one patient and one patient had bilateral involvement. Transcervical excision was the most common approach. Complications were as follows: transient facial nerve paresis n=3 , vagal nerve palsy n=2 , hypoglossal nerve palsy n=2 , permanent facial paralysis n=1 , bleeding n=1 , and total hearing loss n=1 . No recurrences were encountered during a mean follow-up of 71 months. Conclusion: Preoperative evaluation of all patients with respect to catecholamine secretion and multicentric disease is important for choosing the proper treatment and preventing possible complications.

Keywords

Carotid body, head and neck neoplasms, paraganglioma/surgery

Baş-boyun paragangliomları

Abstract

Amaç: Baş-boyun bölgesi paragangliomları nedeniyle tedavi edilen olgular değerlendirildi.Hastalar ve Yöntemler: 1993-2007 yılları arasında, baş-boyun bölgesinde gelişen paragangliom nedeniyle ameliyat edilen 40 hastanın klinik bulguları, uygulanan tedavi yöntemleri ve sonuçları geriye dönük olarak değerlendirildi.Bulgular: En sık başvuru şikayeti boyunda kitle n=30 idi. Diğer şikayetler ise sırasıyla çınlama n=7 , işitme azlığı n=6 , dengesizlik n=3 , ağrı n=2 , ses kısıklığı n=2 , burun tıkanıklığı n=1 idi. Hastalarda şikayet süresi ortalama 22 aydı. En sık rastlanan paragangliom glomus karotikum n=28 idi. Glomus karotikumlu hastalarda tümör çapı ortalama 4.5 cm dağılım 2-12 cm ölçüldü. Hastaların 24’ünde idrarda vanilmandelik asit düzeyi ölçüldü ve iki hastada normalin üzerinde bulundu. On dört hastaya oktreotid sintigrafisi, 27 hastaya femoral anjiyografi yapıldı. Bir hastada multisentrik hastalık, bir hastada iki taraflı tutulum saptandı. Servikal yaklaşımla kitlenin çıkarılması en sık uygulanan girişimdi. Komplikasyon olarak geçici fasyal parezi n=3 , vagus siniri felci n=2 , hipoglossus siniri felci n=2 , kalıcı fasyal paralizi n=1 , kanama n=1 , total işitme kaybı n=1 görüldü. Ortalama 71 ay takip edilen hastalarda nükse rastlanmadı.Sonuç: Hastaların ameliyat öncesi katekolamin sekresyonu ve multisentrisite açısından araştırılması, uygulanacak tedaviyi seçme ve oluşabilecek komplikasyonları önleme açısından önemlidir

Keywords

Karotis cismi, baş-boyun tümörleri, paragangliom/cerrahi

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