四十年来一家机构对双侧头颈部副神经节瘤的管理。
Management of bilateral head and neck paragangliomas at a single-institution across four decades.
作者信息
Bellamkonda Nikhil, Tooker Evan L, Naumer Anne, Buchmann Luke O, Kohlmann Wendy, McCrary Hilary C, Patel Neil S, Espahbodi Mana
机构信息
Department of Otolaryngology - Head and Neck Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
Jefferson Health, Philadelphia, Pennsylvania, USA.
出版信息
Head Neck. 2025 Jan;47(1):386-393. doi: 10.1002/hed.27923. Epub 2024 Aug 21.
BACKGROUND
Bilateral head and neck paragangliomas (HNPGLs) require nuanced management to balance tumor control with functional preservation.
METHODS
All patients seen at a single-institution for bilateral paraganglioma between 1983 and 2023 were retrospectively reviewed. Demographics, genetic testing results, and tumor characteristics were analyzed and compared to treatment modality and cranial nerve outcomes.
RESULTS
There were 49 patients with 116 tumors (90 carotid body tumors [CBTs], 15 vagal paragangliomas [VPs], and 11 jugular paragangliomas [JPs]). Twenty-six patients had SDH pathologic variants (PV). Surgical management was more commonly utilized in younger patients (OR: 0.97, 95% CI: 0.950-0.992) and for JPs (OR: 9, 95% CI: 1.386-58.443). In surgical cases, CBTs had a lower risk of postoperative cranial nerve deficits compared to JPs and VPs (OR: 0.095, 95% CI: 0.013-0.692).
CONCLUSIONS
Younger patients with bilateral HNPGLs, especially those with JP and CBT, are more often treated with surgery. CBTs have lowest risk of cranial nerve deficits after surgery.
背景
双侧头颈部副神经节瘤（HNPGLs）需要细致的管理，以平衡肿瘤控制与功能保留。
方法
对1983年至2023年间在单一机构就诊的所有双侧副神经节瘤患者进行回顾性研究。分析人口统计学、基因检测结果和肿瘤特征，并与治疗方式和颅神经结果进行比较。
结果
49例患者共116个肿瘤（90个颈动脉体瘤[CBTs]、15个迷走神经副神经节瘤[VPs]和11个颈静脉副神经节瘤[JPs]）。26例患者存在琥珀酸脱氢酶（SDH）病理变异（PV）。手术治疗在年轻患者中更常用（OR：0.97，95%CI：0.950-0.992），在JPs患者中也更常用（OR：9，95%CI：1.386-58.443）。在手术病例中，与JPs和VPs相比，CBTs术后颅神经缺损的风险较低（OR：0.095，95%CI：0.013-0.692）。
结论
双侧HNPGLs的年轻患者，尤其是患有JP和CBT的患者，更常接受手术治疗。CBTs术后颅神经缺损的风险最低。
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