Technical Challenges in Temporal Bone Paraganglioma Surgery: a Clinical Review
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Purpose of the Review
Temporal bone paragangliomas have always presented the otologist with their ultimate challenge. Surgical management is difficult, dangerous and demanding. It is also often associated with increased cranial nerve deficits and decreased quality of life for the patient. Management protocols for patients with temporal bone paragangliomas are changing as a result of advances in knowledge and technical developments. Multi-disciplinary care is now recommended for most patients with surgical intervention becoming restricted for the most difficult tumours.
Previously considered unresponsive or resistant to radiotherapy, recent experiences using stereotactic radiosurgery techniques suggest that this is not correct. Tumour growth can be halted in some and slowed down in others. Advances in molecular medicine have defined a number of paraganglioma predisposition syndromes. Recognition of these syndromes is essential. Paragangliomas are now considered to be pioneer models of genetic-based personalised medical care.
This review aims to define the best current management plan for paragangliomas arising in, or involving, the temporal bone. It alerts surgeons to critical phases of surgical technique.
KeywordsTemporal bone paragangliomas Susceptibility genes Inheritance patterns Stereotactic radiosurgery Surgical management
Compliance with Ethical Standards
Conflict of Interest
The authors declare they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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