Wyniki leczenia przyzwojaków kości skroniowej

SummaryIntroductionTemporal bone paragangliomas are rare, benign neuroendocrine tumors. Depend on their location at skull base, they can extend intracranially and extracranially. They characterize by slowly growth and late nonspecific clinical manifestation. Location of tumor and anatomical condition require suitable operational technique and cause related complications.AimThe aim of this study was analysis of surgical procedure and evaluation of treatment results of patients with paragangliomas of the temporal bone hospitalized in Department of Otolaryngology of Warsaw Medical University in years 2000-2010.Material and methods34 cases of patients were retrospectively studied. Clinical data, level of tumor advancement according to Glasscock & Jackson and Fisch classification were analyzed. Intraoperative and imaging studies data were used to evaluate extent of lesions. Suitable operative approaches and outcome of treatment were also analyzed.ResultsIn group of 34 patients 26 of them had monocentric and 8 multicentric neoplasms. Age ranged 15-73-years-old. Most common symptoms were: loss of hearing, tinnitus and headache. Preoperative embolization was carried in 10 cases. Most common surgery technique: tympanotomy and hypotympanotomy posterior and infratemporal fossa of Fisch type A approaches. Radiotherapy was used in 2 cases and surgery with radiation therapy in 7 cases. Most commonly observed complication in surgical treatment was intermittent paresis.Conclusion1.Main aim of temporal bone area paragangliomas treatment is radical removal of tumor.2.Adequate surgical technique is selected according to localization and extension of tumor.3.Preoperative embolization is performed during large paragangliomas treatment.4.Radiotherapy is a good alternative to surgery in selected patients.5.Risk of postoperative cranial nerves palsy rise with level of tumor advancement.