Paragangliomas of the head and neck. Part 2: Therapy and follow-up

Paragangliomas of the head and neck are preferably treated surgically. Planning the surgical approach for temporal bone paragangliomas is performed according to the Fisch classification. Small temporal paragangliomas can be removed in a transtympanic or transmastoidal procedure. Locally advanced paragangliomas of the head and neck have to be embolized presurgically. An occlusion test is also recommended to check the possibility of a resection of the internal carotid artery. Type C and D temporal bone paragangliomas can be removed by different infratemporal approaches. Alternatively, some type C-1,C-2 and De,i(1,2) temporal bone paragangliomas can be removed via variations of the juxtacondlylar approach. Glomus caroticum tumors are resected transcervically. in cases of contraindications for surgery or in palliative situations radiotherapy is recommended.