Paragangliomas of the Head and Neck

Aim: Outlining the different clinical presentations of head and neck paragangliomas and the optimal management policies in our practice.

Method: Overview of 80 head and neck paragangliomas presenting to our department . All patients underwent clinical and radiological evaluation. All patients underwent surgical excision after embolization according to their site. Adjunctive radiation therapy was advocated for selected patients with residual lesions in critical locations.

Results: Total excision was possible in 75 cases. In the remaining small remnants were left on the carotid artery and irradiated. The commonest post-operative morbidity was facial nerve paralysis followed by lower cranial nerve palsies. Facial rehabilitation was performed by either cable grafting or VII–XII anastomosis. Vocal fold paralysis with dysphonia and aspiration was treated by injection thyroplasty and swallowing rehabilitation.

Conclusion: Paragangliomas are not common with a slow insidious onset. Presentation is usually late with large tumors which are surgical challenges. Most cases could be surgically excised with acceptable morbidity. We had no related mortalities.