Long-term results of surgery for temporal bone paragangliomas

Objectives: Assessment of the long-term results of surgery for temporal bon e paragangliomas with special consideration of the patient's ability to cop e with the functional deficits. Study Design: Retrospective review of 36 pa tients who had undergone resection of a temporal bone paraganglioma 10 to 1 5 years previously. Assessment of the patients' subjective view of the func tional outcome and quality of life by a questionnaire. Methods: Clinical re cords were reviewed regarding size of tumor, technique of surgery, supporti ve therapy, and tumor recurrence, Patients were sent a 50-item questionnair e evaluating their quality of life and the preoperative and postoperative f unction of cranial nerves VII through XII. Results: A. complete tumor remov al was achieved in 30 patients (83%). There was only one tumor recurrence. The major negative effects of surgery involved hearing and dysphagia, which deterioriated in 14 and 12 patients, respectively. Thirty-five of the 36 p atients (97%) reported that, despite deterioration, the cranial nerve defic its were still acceptable, Seventy-five percent of the patients regained th eir preoperative quality of life and 97% returned to their previous occupat ion in 1 to 2 years. Conclusions: The otologic extradural approach allowed complete tumor removal in 83%, with minimal perioperative morbidity, No sur gically induced central nervous system lesions occured. Tracheostomy was av oided and all patients resumed oral feeding. Full rehabilitation after remo val of class C and CD paragangliomas may take 1 to 2 years. However, the fa ct that 97% of the patients finally resumed normal social life showed the a bility of most patients to cope with the sequelae of surgery even in class C and CD paragangliomas. Key Words: Temporal bone paragangliomas, glomus ju gulare tumors, skull base surgery.