Head and neck paragangliomas: 30‐year experience
Cristina Valero, Ian Ganly, Jatin P. Shah
Abstract
BACKGROUND: We aimed to review our experience and the changing trends in the management of head and neck paragangliomas (HNPG) over the last three decades. METHODS: We retrospectively reviewed 103 patients with HNPG treated at our center (1986-2017). We included patients treated with surgery, radiotherapy, and patients maintained under active surveillance. RESULTS: Of the surgically treated patients (n = 79), 20% (12/59) of the carotid body tumors (CBT) had a cranial nerve deficit as sequela compared to 95% (19/20) of the non-CBT. Radiotherapy controlled growth in all tumors treated with this modality (n = 10). Of the initially observed patients, 70% (14/20) remained stable and did not require additional treatment. Stratifying by decades, there was a progressive increase in patients initially attempted to be observed and a decrease in upfront surgery. No deaths attributable to the HNPG were encountered. CONCLUSIONS: Surgery is an effective treatment for CBT. Nonsurgical treatment should be considered for non-CBT.