Tympanic paraganglioma—Resection techniques

Tympanic paragangliomas (TP) arise in the middle ear along the course of Jacobson׳s or Arnold׳s nerve. These lesions can vary from small masses on the cochlear promontory to tumors that extend into the mastoid and external auditory canal. Surgical excision is the treatment of choice for TP with very low-recurrence rates. The various surgical approaches for TP are adapted to the configuration of individual tumors to provide adequate exposure to the margins of the tumor in the mesotympanum, hypotympanum, and mastoid. Using these surgical approaches in combination with meticulous dissection and hemostasis with adjunctive tools such as laser and micro-bipolar instruments allows for safe and effective resection of these vascular tumors from within the confines of the tympanic cavity.