Paragangliomas of the head and neck HNPGL and relatively rare tumours. They may arise in the middle ear, at the base of the skull, or related to vessels and nerves in the neck. Sporadic tumours are generally solitary but up to one third of cases will have tumours that are part of a familial syndrome which may be multiple in the head and neck or associated with similar tumours in other parts of the body.
Successful management depends on comprehensive assessment including physical examination, detailed imaging, identification of those secreting hormone and genetic screening.
Management options include observation, radiation and surgery. Decision to treat and the mode of treatment chosen are strongly influenced by the patient’s clinical presentation as well as specific tumour factors.
Classification systems have been developed for skull base and carotid body tumours based on imaging features of tumour site(s), spread, including the posterior cranial fossa and involvement of other structures such as the carotid artery. These are used in planning surgical approaches for resection and assessing potential morbidity of surgery. Radiation may be used as sole treatment or as an adjunct to surgery.
This presentation will cover our approach to patient assessment, treatment decision making, surgical approaches and outcomes