Stephan Hackenberg1, Till Jasper Meyer2, Johannes Häfner3, Matthias Scheich3, Manuel Stöth3, Fadi Al-Tinawi4, Tilmann Neun4, Robert Mlynski5, Rudolf Hagen3, Agmal Scherzad3. 1. Department of Otorhinolaryngology - Head and Neck Surgery, RWTH Aachen University Hospital, Aachen, Germany. 2. Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg University Hospital, Würzburg, Germany. meyer_t2@ukw.de. 3. Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg University Hospital, Würzburg, Germany. 4. Institute for Diagnostic and Interventional Neuroradiology, Würzburg University Hospital, Würzburg, Germany. 5. Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany.
Abstract
PURPOSE: Surgery is a standard therapy for tympanojugular paragangliomas (TJP). Maintaining the quality of life (QoL) requires functional preservation. The flexible CO2 laser allows contact-free tumor removal. This retrospective study compares the postoperative functional outcomes of TJP surgery with and without the flexible CO2 laser. METHODS: Between 2005 and 2019, 51 patients with TJP were surgically treated at a tertiary hospital. Until 2012, 17 patients received conventional surgery. Thereafter, the flexible laser was used in 34 patients. Tumor extend, pre- and postoperative cranial nerve function, and complications were compared between the groups. RESULTS: The cohort consisted of 33 class A and B tumors and 18 class C and D tumors. Preoperative embolization was performed in 17 cases. Class C/D TJP were usually removed via an infratemporal fossa type A approach. Gross total tumor removal was achieved in 14/18 class C/D tumors. 3/51 patients suffered from long-term partial or complete facial palsy. No differences in post-therapeutic cranial nerve function or complications were noted between the conventional and laser group. One recurrence was observed after complete tumor resection. CONCLUSION: The flexible CO2 laser was shown to be a safe and effective alternative to conventional bipolar cauterization, which is appreciated by the surgeon in these highly vascularized tumors. Both techniques allowed a high tumor control rate and good long-term results also from a functional point of view.
PURPOSE: Surgery is a standard therapy for tympanojugular paragangliomas (TJP). Maintaining the quality of life (QoL) requires functional preservation. The flexible CO2 laser allows contact-free tumor removal. This retrospective study compares the postoperative functional outcomes of TJP surgery with and without the flexible CO2 laser. METHODS: Between 2005 and 2019, 51 patients with TJP were surgically treated at a tertiary hospital. Until 2012, 17 patients received conventional surgery. Thereafter, the flexible laser was used in 34 patients. Tumor extend, pre- and postoperative cranial nerve function, and complications were compared between the groups. RESULTS: The cohort consisted of 33 class A and B tumors and 18 class C and D tumors. Preoperative embolization was performed in 17 cases. Class C/D TJP were usually removed via an infratemporal fossa type A approach. Gross total tumor removal was achieved in 14/18 class C/D tumors. 3/51 patients suffered from long-term partial or complete facial palsy. No differences in post-therapeutic cranial nerve function or complications were noted between the conventional and laser group. One recurrence was observed after complete tumor resection. CONCLUSION: The flexible CO2 laser was shown to be a safe and effective alternative to conventional bipolar cauterization, which is appreciated by the surgeon in these highly vascularized tumors. Both techniques allowed a high tumor control rate and good long-term results also from a functional point of view.
Authors: Andrea Bacciu; Hassan Ait Mimoune; Flavia D'Orazio; Francesca Vitullo; Alessandra Russo; Mario Sanna Journal: J Neurol Surg B Skull Base Date: 2013-08-21