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Head and neck paragangliomas

Yıl 2008, Cilt: 18 Sayı: 6, 343 - 348, 20.12.2008

Öz

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.

Kaynakça

  • Pellitteri PK, Rinaldo A, Myssiorek D, Gary Jackson C, Bradley PJ, Devaney KO, et al. Paragangliomas of the head and neck. Oral Oncol 2004;40:563-75.
  • Lee JH, Barich F, Karnell LH, Robinson RA, Zhen WK, Gantz BJ, et al. National Cancer Data Base report on malignant paragangliomas of the head and neck. Cancer 2002;94:730-7.
  • Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics of head and neck tumours (World Health Organization classification of tumours). Lyon: IARC Press; 2005.
  • Manolidis S, Shohet JA, Jackson CG, Glasscock ME 3rd. Malignant glomus tumors. Laryngoscope 1999; 109:30-4.
  • Rinaldo A, Myssiorek D, Devaney KO, Ferlito A. Which paragangliomas of the head and neck have a higher rate of malignancy? Oral Oncol 2004;40:458-60.
  • Köhler HF, Carvalho AL, Mattos Granja NV, Nishinari K, Kowalski LP. Surgical treatment of paragangliomas of the carotid bifurcation: results of 36 patients. Head Neck 2004;26:1058-63.
  • Bernard RP. Carotid body tumors. Am J Surg 1992; 163:494-6.
  • Boedeker CC, Ridder GJ, Schipper J. Paragangliomas of the head and neck: diagnosis and treatment. Fam Cancer 2005;4:55-9.
  • Duet M, Sauvaget E, Pételle B, Rizzo N, Guichard JP, Wassef M, et al. Clinical impact of somatostatin recep- tor scintigraphy in the management of paragangliomas of the head and neck. J Nucl Med 2003;44:1767-74.
  • van Essen M, Krenning EP, Kooij PP, Bakker WH, Feelders RA, de Herder WW, et al. Effects of therapy with [177Lu-DOTA0, Tyr3]octreotate in patients with paraganglioma, meningioma, small cell lung carci- noma, and melanoma. J Nucl Med 2006;47:1599-606.
  • Plukker JT, Brongers EP, Vermey A, Krikke A, van den Dungen JJ. Outcome of surgical treatment for carotid body paraganglioma. Br J Surg 2001;88:1382-6.
  • Evenson LJ, Mendenhall WM, Parsons JT, Cassisi NJ. Radiotherapy in the management of chemodectomas of the carotid body and glomus vagale. Head Neck 1998;20:609-13.
  • Persky MS, Setton A, Niimi Y, Hartman J, Frank D, Berenstein A. Combined endovascular and surgical treatment of head and neck paragangliomas-a team approach. Head Neck 2002;24:423-31.
  • Remley KB, Coit WE, Harnsberger HR, Smoker WR, Jacobs JM, McIff EB. Pulsatile tinnitus and the vascu- lar tympanic membrane: CT, MR, and angiographic findings. Radiology 1990;174:383-9.
  • Cohen SM, Netterville JL. Surgical management of vagal paragangliomas. Operative Techniques in Otolaryngology 2004;15:196-200.
  • Biller HF, Lawson W, Som P, Rosenfeld R. Glomus vagale tumors. Ann Otol Rhinol Laryngol 1989;98:21-6.
  • Urquhart AC, Johnson JT, Myers EN, Schechter GL. Glomus vagale: paraganglioma of the vagus nerve. Laryngoscope 1994;104:440-5.
  • Miller RB, Boon MS, Atkins JP, Lowry LD. Vagal paraganglioma: the Jefferson experience. Otolaryngol Head Neck Surg 2000;122:482-7.
  • Rubin AD, Cheng SS, Bradford CR. Laryngeal para- ganglioma in a patient with multiple head and neck paragangliomas. Otolaryngol Head Neck Surg 2005;132:520-2.
  • Gökler A, Akın İ, Vural A, Gürzümar A. Supraglottik yerleşimli bir larengeal paraganglioma vakası. K.B.B. ve Baş Boyun Cerrahisi Dergisi 1993;l:37-9.
  • Üçüncü H, Aktan B, Erdoğan F, Eren S, Sütbeyaz Y. Laryngeal paraganglioma causing airway obstruction: a case report. Turk Arch Otolaryngol 2005;43:37-41.
  • Myssiorek D, Rinaldo A, Barnes L, Ferlito A. Laryngeal paraganglioma: an updated critical review. Acta Otolaryngol 2004;124:995-9.
  • Branham GH, Gnepp DR, O’McMenomey S, Friedman WH. Malignant paraganglioma-a case report and lit- erature review. Otolaryngol Head Neck Surg 1989; 101:99-103.
  • Lecanu JB, Arkwright S, Halimi PH, Trotoux J, Bonfils P. Multifocal malignant paraganglioma of the parana- sal sinuses: a case report. Otolaryngol Head Neck Surg 2002;126:445-7.
  • Myssiorek D, Halaas Y, Silver C. Laryngeal and sinona- sal paragangliomas. Otolaryngol Clin North Am 2001; 34:971-82.
  • Mouadeb DA, Chandra RK, Kennedy DW, Feldman M. Sinonasal paraganglioma: endoscopic resection with a 4-year follow-up. Head Neck 2003;25:1077-81.

Baş-boyun paragangliomları

Yıl 2008, Cilt: 18 Sayı: 6, 343 - 348, 20.12.2008

Öz

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

Kaynakça

  • Pellitteri PK, Rinaldo A, Myssiorek D, Gary Jackson C, Bradley PJ, Devaney KO, et al. Paragangliomas of the head and neck. Oral Oncol 2004;40:563-75.
  • Lee JH, Barich F, Karnell LH, Robinson RA, Zhen WK, Gantz BJ, et al. National Cancer Data Base report on malignant paragangliomas of the head and neck. Cancer 2002;94:730-7.
  • Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Pathology and genetics of head and neck tumours (World Health Organization classification of tumours). Lyon: IARC Press; 2005.
  • Manolidis S, Shohet JA, Jackson CG, Glasscock ME 3rd. Malignant glomus tumors. Laryngoscope 1999; 109:30-4.
  • Rinaldo A, Myssiorek D, Devaney KO, Ferlito A. Which paragangliomas of the head and neck have a higher rate of malignancy? Oral Oncol 2004;40:458-60.
  • Köhler HF, Carvalho AL, Mattos Granja NV, Nishinari K, Kowalski LP. Surgical treatment of paragangliomas of the carotid bifurcation: results of 36 patients. Head Neck 2004;26:1058-63.
  • Bernard RP. Carotid body tumors. Am J Surg 1992; 163:494-6.
  • Boedeker CC, Ridder GJ, Schipper J. Paragangliomas of the head and neck: diagnosis and treatment. Fam Cancer 2005;4:55-9.
  • Duet M, Sauvaget E, Pételle B, Rizzo N, Guichard JP, Wassef M, et al. Clinical impact of somatostatin recep- tor scintigraphy in the management of paragangliomas of the head and neck. J Nucl Med 2003;44:1767-74.
  • van Essen M, Krenning EP, Kooij PP, Bakker WH, Feelders RA, de Herder WW, et al. Effects of therapy with [177Lu-DOTA0, Tyr3]octreotate in patients with paraganglioma, meningioma, small cell lung carci- noma, and melanoma. J Nucl Med 2006;47:1599-606.
  • Plukker JT, Brongers EP, Vermey A, Krikke A, van den Dungen JJ. Outcome of surgical treatment for carotid body paraganglioma. Br J Surg 2001;88:1382-6.
  • Evenson LJ, Mendenhall WM, Parsons JT, Cassisi NJ. Radiotherapy in the management of chemodectomas of the carotid body and glomus vagale. Head Neck 1998;20:609-13.
  • Persky MS, Setton A, Niimi Y, Hartman J, Frank D, Berenstein A. Combined endovascular and surgical treatment of head and neck paragangliomas-a team approach. Head Neck 2002;24:423-31.
  • Remley KB, Coit WE, Harnsberger HR, Smoker WR, Jacobs JM, McIff EB. Pulsatile tinnitus and the vascu- lar tympanic membrane: CT, MR, and angiographic findings. Radiology 1990;174:383-9.
  • Cohen SM, Netterville JL. Surgical management of vagal paragangliomas. Operative Techniques in Otolaryngology 2004;15:196-200.
  • Biller HF, Lawson W, Som P, Rosenfeld R. Glomus vagale tumors. Ann Otol Rhinol Laryngol 1989;98:21-6.
  • Urquhart AC, Johnson JT, Myers EN, Schechter GL. Glomus vagale: paraganglioma of the vagus nerve. Laryngoscope 1994;104:440-5.
  • Miller RB, Boon MS, Atkins JP, Lowry LD. Vagal paraganglioma: the Jefferson experience. Otolaryngol Head Neck Surg 2000;122:482-7.
  • Rubin AD, Cheng SS, Bradford CR. Laryngeal para- ganglioma in a patient with multiple head and neck paragangliomas. Otolaryngol Head Neck Surg 2005;132:520-2.
  • Gökler A, Akın İ, Vural A, Gürzümar A. Supraglottik yerleşimli bir larengeal paraganglioma vakası. K.B.B. ve Baş Boyun Cerrahisi Dergisi 1993;l:37-9.
  • Üçüncü H, Aktan B, Erdoğan F, Eren S, Sütbeyaz Y. Laryngeal paraganglioma causing airway obstruction: a case report. Turk Arch Otolaryngol 2005;43:37-41.
  • Myssiorek D, Rinaldo A, Barnes L, Ferlito A. Laryngeal paraganglioma: an updated critical review. Acta Otolaryngol 2004;124:995-9.
  • Branham GH, Gnepp DR, O’McMenomey S, Friedman WH. Malignant paraganglioma-a case report and lit- erature review. Otolaryngol Head Neck Surg 1989; 101:99-103.
  • Lecanu JB, Arkwright S, Halimi PH, Trotoux J, Bonfils P. Multifocal malignant paraganglioma of the parana- sal sinuses: a case report. Otolaryngol Head Neck Surg 2002;126:445-7.
  • Myssiorek D, Halaas Y, Silver C. Laryngeal and sinona- sal paragangliomas. Otolaryngol Clin North Am 2001; 34:971-82.
  • Mouadeb DA, Chandra RK, Kennedy DW, Feldman M. Sinonasal paraganglioma: endoscopic resection with a 4-year follow-up. Head Neck 2003;25:1077-81.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

İmdat Yüce Bu kişi benim

Sedat Çağlı Bu kişi benim

Ali Bayram Bu kişi benim

Ercihan Güney Bu kişi benim

Yayımlanma Tarihi 20 Aralık 2008
Yayımlandığı Sayı Yıl 2008 Cilt: 18 Sayı: 6

Kaynak Göster

APA Yüce, İ., Çağlı, S., Bayram, A., Güney, E. (2008). Baş-boyun paragangliomları. The Turkish Journal of Ear Nose and Throat, 18(6), 343-348.
AMA Yüce İ, Çağlı S, Bayram A, Güney E. Baş-boyun paragangliomları. Tr-ENT. Aralık 2008;18(6):343-348.
Chicago Yüce, İmdat, Sedat Çağlı, Ali Bayram, ve Ercihan Güney. “Baş-Boyun Paragangliomları”. The Turkish Journal of Ear Nose and Throat 18, sy. 6 (Aralık 2008): 343-48.
EndNote Yüce İ, Çağlı S, Bayram A, Güney E (01 Aralık 2008) Baş-boyun paragangliomları. The Turkish Journal of Ear Nose and Throat 18 6 343–348.
IEEE İ. Yüce, S. Çağlı, A. Bayram, ve E. Güney, “Baş-boyun paragangliomları”, Tr-ENT, c. 18, sy. 6, ss. 343–348, 2008.
ISNAD Yüce, İmdat vd. “Baş-Boyun Paragangliomları”. The Turkish Journal of Ear Nose and Throat 18/6 (Aralık 2008), 343-348.
JAMA Yüce İ, Çağlı S, Bayram A, Güney E. Baş-boyun paragangliomları. Tr-ENT. 2008;18:343–348.
MLA Yüce, İmdat vd. “Baş-Boyun Paragangliomları”. The Turkish Journal of Ear Nose and Throat, c. 18, sy. 6, 2008, ss. 343-8.
Vancouver Yüce İ, Çağlı S, Bayram A, Güney E. Baş-boyun paragangliomları. Tr-ENT. 2008;18(6):343-8.