Urquhart A C, Johnson J T, Myers E N, Schechter G L
Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye & Ear Institute of Pittsburgh, PA 15213.
Laryngoscope. 1994 Apr;104(4):440-5. doi: 10.1288/00005537-199404000-00008.
Review of the experience of a single institution with a rare tumor may give inadequate and biased information. In an effort to better understand issues related to diagnosis and subsequent management of paraganglioma of the vagus nerve, review of the experience at two university medical centers was undertaken. A review of the records of all patients with a diagnosis of vagal paraganglioma at the University of Pittsburgh and the Eastern Virginia Medical School was undertaken. Presenting signs and symptoms, treatment, and subsequent outcome were assessed. Data on 19 patients with vagal paraganglioma were available. The most common initial finding was a neck mass. Forty-seven percent (9/19) had vocal cord paralysis at presentation. Angiography was beneficial in helping to make the diagnosis and in identifying synchronous tumors. History of familial paraganglioma was present in 47% (9/19). Multiple paragangliomas were diagnosed in 53% (10/19) cases in our study. Of the patients with familial vagal paraganglioma, 89% (8/9) had multiple paraganglioma. All patients treated with surgery had postoperative vocal cord paralysis. Elective management of patients with bilateral vagal paraganglioma is a special dilemma. Radiation therapy of selected "operable" patients may be indicated because of the potential for bilateral vocal cord paralysis in these patients and its attendant sequela.
对单一机构中罕见肿瘤治疗经验的回顾可能会提供不充分且有偏差的信息。为了更好地理解与迷走神经副神经节瘤的诊断及后续治疗相关的问题，我们对两所大学医学中心的经验进行了回顾。我们查阅了匹兹堡大学和东弗吉尼亚医学院所有诊断为迷走神经副神经节瘤患者的病历。对患者的症状表现、治疗方法及后续结果进行了评估。我们获得了19例迷走神经副神经节瘤患者的数据。最常见的首发症状是颈部肿块。47%（9/19）的患者在初诊时有声带麻痹。血管造影有助于诊断并识别同步肿瘤。47%（9/19）的患者有家族性副神经节瘤病史。在我们的研究中，53%（10/19）的病例诊断为多发副神经节瘤。在家族性迷走神经副神经节瘤患者中，89%（8/9）有多发副神经节瘤。所有接受手术治疗的患者术后均出现声带麻痹。双侧迷走神经副神经节瘤患者的择期治疗是一个特殊的难题。对于部分“可手术”患者，由于其存在双侧声带麻痹的可能性及其相关后遗症，可能需要进行放射治疗。
