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DOI: 10.1055/s-0042-1742766
Postauricular Transcanal Posterior Tympanectomy (PT2) Approach – A Modified Surgical Technique for Jugulotympanic Paragangliomas
Funding The author(s) received no financial support for the research.
Abstract
Introduction The surgical management of jugulotympanic paragangliomas has remained challenging. They are the second most common type of tumor of the temporal bone after acoustic neuroma. It has been noticed by the authors that the jugulotympanic paragangliomas may have extensions to the epitympanum and aditus in addition to the mesotympanum and hypotympanum. The modified technique could be an alternative to the conventional facial recess technique for complete removal of the tumors.
Objective To highlight the modified surgical technique for the surgical treatment of jugulotympanic paragangliomas.
Methods This is a retrospective review of 34 cases of jugulotympanic paragangliomas treated in a tertiary center with respect to clinical presentation, diagnosis, and surgical treatment. Tinnitus and hearing loss were predominant symptoms. A modified technique of postauricular transcanal posterior tympanectomy with extended hypotympanic access was performed in 29 patients. Only two cases were operated with a classical transcanal approach. A canal wall down the mastoidectomy was required in three patients.
Results The patients operated on with the modified technique had complete excision evident by absence of any lesion in computed tomography and the disappearance of tinnitus. However, two patients had recurrence of symptoms and presence of tumor in the follow-up period. These two patients underwent revision surgery. None of the patients required postoperative radiotherapy or gamma knife therapy.
Conclusions Jugulotympanic paragangliomas can be effectively managed with the modified technique to ensure complete removal of the lesions. This technique has not been reported earlier in the literature.
Institute Ethics Committee Protocol No/Reference no NK/6313/study/636
Publication History
Received: 29 June 2021
Accepted: 16 November 2021
Article published online:
04 August 2023
© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Rossenwasser H. Carotid body tumor of the middle ear and mastoid. Arch Otolaryngol 1945; 41: 64-67
- 2 Oldring D, Fisch U. Glomus tumors of the temporal region: surgical therapy. Am J Otol 1979; 1 (01) 7-18
- 3 Jackson CG, Glasscock III ME, Harris PF. Glomus Tumors. Diagnosis, classification, and management of large lesions. Arch Otolaryngol 1982; 108 (07) 401-410
- 4 House WF, Glasscock III ME. Glomus tympanicum tumors. Arch Otolaryngol 1968; 87 (05) 550-554
- 5 Guild SR. A hitherto unrecognized structure- the Glomus jugularis. Man Anat. Rec 1941; 70: 28
- 6 Pollak N, Soni RS. Endoscopic excision of a tympanic paraganglioma: Training the next generation of ear surgeons. World J Otorhinolaryngol Head Neck Surg 2017; 3 (03) 160-162
- 7 Mohammed AAS, Ahmed HS, Abdullah MAM, Badr-El-Dine MMK. Transcanal endoscopic excision of tympanic paraganglioma, a report of our surgical technique. The Egyptian J Neck Surgery Otorhinolaryngology. 2020; 6 (01) 1-9
- 8 Shambaugh Jr GE. Surgical approach for so-called glomus jugulare tumors of the middle ear. Laryngoscope 1955; 65 (04) 185-198
- 9 Farrior JB. Glomus tumors. Postauricular hypotympanotomy and hypotympanoplasty. Arch Otolaryngol 1967; 86 (04) 367-373
- 10 Jethanamest D. Tympanic paraganglioma. Resection techniques. Operation Techniques in Otolaryngology 2016; 27: 15-19