Surgical management of vagal paraganglioma

Vagal paragangliomas are nonchromaffin tumors that originate from paraganglionic chemoreceptor cell bodies associated with the vagus nerve. Although both surgical excision and radiation therapy have been reported to be effective treatment modalities, the effectiveness of one over the other remains unclear. There are several surgical approaches that have been described. As with any surgical disease, the utility of a technique over another has been justified at some point in time. Clearly, there has been a shift away from the more radical approaches with the primary goal of surgery being complete extirpation of the tumor along with avoidance of iatrogenic cranial neuropathies and preservation and restoration of cranial nerve function. In addition, early rehabilitation of speech and swallowing dysfunction results in improved functional outcomes and reduced hospital stay and morbidity.