H Odat1, S-H Shin2, M A Odat3, F Alzoubi1. 1. Division of Otolaryngology,Department of Special Surgery,Faculty of Medicine,Jordan University of Science and Technology,Irbid,Jordan. 2. Department of Otorhinolaryngology - Head and Neck Surgery,School of Medicine,Ewha Womans University,Seoul,Korea. 3. Department of Special Surgery,King Hussein Medical Centre,Royal Medical Services of Jordan,Amman,Jordan.
Abstract
OBJECTIVE: This literature review analysed facial nerve management strategies in jugular paraganglioma surgery and discusses the tumour resection rate and the facial nerve outcome associated with each technique. METHODS: A retrospective review of PubMed and Medline articles on the surgical treatments for jugular paraganglioma was performed. Tumour resection rates and post-operative facial nerve function after non-rerouting, short anterior rerouting and long anterior rerouting approaches were evaluated for each article. RESULTS: A total of 15 studies involving a total of 688 patients were included. Post-operative facial nerve function was similar after non-rerouting and short anterior rerouting approaches (p = 0.169); however, both of these techniques had significantly better post-operative facial nerve outcomes compared with long anterior rerouting (p < 0.001 and p = 0.001, respectively). The total tumour removal rate was significantly higher for long anterior rerouting than with the non-rerouting approach (p = 0.016). There was no difference in total tumour removal rate between the long and short anterior rerouting approaches (p = 0.067) and between the short anterior rerouting and non-rerouting approaches (p = 0.867). CONCLUSION: No strict guidelines for facial nerve management in jugular paraganglioma resection are available. Although long anterior rerouting provides the best tumour exposure along with a low morbidity rate, case-by-case selection of the surgical approach is recommended.
OBJECTIVE: This literature review analysed facial nerve management strategies in jugular paraganglioma surgery and discusses the tumour resection rate and the facial nerve outcome associated with each technique. METHODS: A retrospective review of PubMed and Medline articles on the surgical treatments for jugular paraganglioma was performed. Tumour resection rates and post-operative facial nerve function after non-rerouting, short anterior rerouting and long anterior rerouting approaches were evaluated for each article. RESULTS: A total of 15 studies involving a total of 688 patients were included. Post-operative facial nerve function was similar after non-rerouting and short anterior rerouting approaches (p = 0.169); however, both of these techniques had significantly better post-operative facial nerve outcomes compared with long anterior rerouting (p < 0.001 and p = 0.001, respectively). The total tumour removal rate was significantly higher for long anterior rerouting than with the non-rerouting approach (p = 0.016). There was no difference in total tumour removal rate between the long and short anterior rerouting approaches (p = 0.067) and between the short anterior rerouting and non-rerouting approaches (p = 0.867). CONCLUSION: No strict guidelines for facial nerve management in jugular paraganglioma resection are available. Although long anterior rerouting provides the best tumour exposure along with a low morbidity rate, case-by-case selection of the surgical approach is recommended.
Authors: Benedicto Oscar Colli; Carlos Gilberto Carlotti Junior; Ricardo Santos de Oliveira; Guilherme Gozzoli Podolski Gondim; Daniel Giansanti Abud; Eduardo Tanaka Massuda; Francisco Veríssimo de Melo Filho; Koji Tanaka Journal: Surg Neurol Int Date: 2021-09-30