Vagal paraganglioma: A review of 46 patients treated during a 20-year period

James L. Netterville, C. Gary Jackson, Frank R Miller, John R. Wanamaker, Michael E. Glasscock

Research output: Contribution to journalArticle

191 Citations (Scopus)

Abstract

Background: Vagal paragangliomas (VPs) arise from paraganglia associated with the vagus nerve. Approximately 200 cases have been reported in the medical literature. Because of their rarity, most information regarding these tumors has arisen from case reports and small clinical series. Objective: To detail the clinicopathological features of 46 patients with VP with an emphasis on the role of a multidisciplinary skull base team in both the successful extirpation and rehabilitation. Design: Retrospective review of 46 patients with VP managed by a single skull base team. Setting: An academic tertiary medical center. Results: Forty-six patients were treated over a 20- year period (1978-1988). Ten (22%) demonstrated intracranial extension. There was a history of familial paragangliomas in 9 (20%) of the patients. The incidence of multicentric paragangliomas was 78% in patients with familial paragangliomas vs 23% in patients with nonfamilial paragangliomas. Management of this group of 46 patients consisted of surgery (n = 40), radiation therapy (n = 4), and observation (n = 2). The operative approach consisted of a transcervical excision often combined with a transtemporal or lateral skull base approach as dictated by the tumor extent. Postoperative cranial nerve deficits were common, and, as such, aggressive rehabilitation was a vital component in the management of these tumors. Conclusions: The management of VP and its associated cranial nerve deficits remains a difficult clinical problem. Options for treatment include surgical resection, radiation therapy, and, in selected cases, observation. Surgical extirpation requires a multidisciplinary skull base team to achieve complete tumor resection. Radiation therapy is reserved for elderly patients and patients at risk for bilateral cranial nerve deficits. Rehabilitation of cranial nerve deficits is an integral part of the management of VP.

Original languageEnglish (US)
Pages (from-to)1133-1140
Number of pages8
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume124
Issue number10
StatePublished - Oct 1998
Externally publishedYes

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Paraganglioma
Cranial Nerves
Skull Base
Radiotherapy
Rehabilitation
Neoplasms
Observation
Vagus Nerve

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Netterville, J. L., Jackson, C. G., Miller, F. R., Wanamaker, J. R., & Glasscock, M. E. (1998). Vagal paraganglioma: A review of 46 patients treated during a 20-year period. Archives of Otolaryngology - Head and Neck Surgery, 124(10), 1133-1140.

Vagal paraganglioma : A review of 46 patients treated during a 20-year period. / Netterville, James L.; Jackson, C. Gary; Miller, Frank R; Wanamaker, John R.; Glasscock, Michael E.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 124, No. 10, 10.1998, p. 1133-1140.

Research output: Contribution to journalArticle

Netterville, JL, Jackson, CG, Miller, FR, Wanamaker, JR & Glasscock, ME 1998, 'Vagal paraganglioma: A review of 46 patients treated during a 20-year period', Archives of Otolaryngology - Head and Neck Surgery, vol. 124, no. 10, pp. 1133-1140.
Netterville, James L. ; Jackson, C. Gary ; Miller, Frank R ; Wanamaker, John R. ; Glasscock, Michael E. / Vagal paraganglioma : A review of 46 patients treated during a 20-year period. In: Archives of Otolaryngology - Head and Neck Surgery. 1998 ; Vol. 124, No. 10. pp. 1133-1140.
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