Management of bilateral head and neck paragangliomas at a single-institution across four decades.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-08-21 DOI:10.1002/hed.27923

Nikhil Bellamkonda, Evan L Tooker, Anne Naumer, Luke O Buchmann, Wendy Kohlmann, Hilary C McCrary, Neil S Patel, Mana Espahbodi

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Abstract

Background: Bilateral head and neck paragangliomas (HNPGLs) require nuanced management to balance tumor control with functional preservation.

Methods: All patients seen at a single-institution for bilateral paraganglioma between 1983 and 2023 were retrospectively reviewed. Demographics, genetic testing results, and tumor characteristics were analyzed and compared to treatment modality and cranial nerve outcomes.

Results: There were 49 patients with 116 tumors (90 carotid body tumors [CBTs], 15 vagal paragangliomas [VPs], and 11 jugular paragangliomas [JPs]). Twenty-six patients had SDH pathologic variants (PV). Surgical management was more commonly utilized in younger patients (OR: 0.97, 95% CI: 0.950-0.992) and for JPs (OR: 9, 95% CI: 1.386-58.443). In surgical cases, CBTs had a lower risk of postoperative cranial nerve deficits compared to JPs and VPs (OR: 0.095, 95% CI: 0.013-0.692).

Conclusions: Younger patients with bilateral HNPGLs, especially those with JP and CBT, are more often treated with surgery. CBTs have lowest risk of cranial nerve deficits after surgery.

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一家医疗机构四十年来对双侧头颈部副神经节瘤的治疗。

背景：双侧头颈部副神经节瘤（HNPGLs）需要细致入微的管理，以平衡肿瘤控制与功能保护：方法：回顾性研究了1983年至2023年间在一家机构就诊的所有双侧副神经节瘤患者。对人口统计学、基因检测结果和肿瘤特征进行分析，并将其与治疗方式和颅神经结果进行比较：共有49名患者，116个肿瘤（90个颈动脉体瘤[CBTs]、15个迷走神经旁神经节瘤[VPs]和11个颈静脉旁神经节瘤[JPs]）。26例患者有SDH病理变异（PV）。手术治疗更多用于年轻患者（OR：0.97，95% CI：0.950-0.992）和 JPs（OR：9，95% CI：1.386-58.443）。在手术病例中，CBT与JP和VP相比，术后出现颅神经缺损的风险较低（OR：0.095，95% CI：0.013-0.692）：结论：年轻的双侧 HNPGLs 患者，尤其是 JP 和 CBT 患者，更常接受手术治疗。CBT患者术后出现颅神经缺损的风险最低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.