Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Department of Otolaryngology Head and Neck Surgery, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Otolaryngol Head Neck Surg. 2020 Sep;163(3):400-409. doi: 10.1177/0194599820915490. Epub 2020 Apr 28.
The management of head and neck paragangliomas (HNPGLs) has changed significantly in recent years. There is, however, an absence of guidance in the literature regarding the optimal means of managing this challenging disease. This consensus document, developed by the British Skull Base Society, sets out recommendations for management of HNPGLs. A preliminary document was produced on the basis of current practice in 3 large UK skull base centers, incorporating relevant peer-reviewed evidence. This document was then modified by discussion within these units, through a national survey of British Skull Base Society members, and through discussion with stakeholders. A consensus was reached on the management of all forms of HNPGL. All patients should be managed by a multidisciplinary team and require initial surgical, endocrine, and genetic assessments as well as magnetic resonance imaging of the head, neck, chest, abdomen, and pelvis. Long-term preservation of function is the primary treatment goal, with conservative management the first choice treatment for most tumors. Radiotherapy is a safe, effective treatment for growing tumors in most cases, although there is a limited role for surgery. Screening of family members in high-risk groups is mandatory. These guidelines should help standardize high-quality care for patients with HNPGLs.
近年来，头颈部副神经节瘤（HNPGL）的管理发生了重大变化。然而，文献中缺乏关于管理这种具有挑战性疾病的最佳方法的指导。本共识文件由英国颅底学会制定，提出了 HNPGL 管理的建议。一份初步文件是基于 3 家英国颅底中心的当前实践制定的，纳入了相关的同行评议证据。然后，通过这些单位内部讨论、英国颅底学会成员的全国性调查以及与利益相关者的讨论对该文件进行了修改。就所有形式的 HNPGL 的管理达成了共识。所有患者都应由多学科团队管理，需要进行初步的手术、内分泌和遗传评估，以及头部、颈部、胸部、腹部和骨盆的磁共振成像。长期保留功能是主要的治疗目标，对于大多数肿瘤，保守治疗是首选治疗。在大多数情况下，放射治疗是生长肿瘤的安全有效治疗方法，尽管手术的作用有限。高危人群的家庭成员筛查是强制性的。这些指南应有助于为 HNPGL 患者提供标准化的高质量护理。
