Endoscopic Management of Middle Ear Paragangliomas: A Case Series

Daniel E. Killeen, Cameron C. Wick, Jacob B. Hunter, Alejandro Rivas, George B. Wanna, João Flávio Nogueira, Joe Walter Kutz, Brandon Isaacson

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To investigate the efficacy and safety of endoscopic middle ear paraganglioma (glomus tympanicum) resection. Study Design: Case series with chart review. Setting: Multi-institutional tertiary university medical centers. Patients: Adult patients with middle ear paragangliomas treated via a transcanal endoscopic approach from 1/2012 to 11/2015. Intervention: All tumors were initially approached via a transcanal endoscopic technique. An operating microscope was used only if the tumor could not be adequately visualized or resected with endoscopic techniques alone. Main Outcome Measures: The main outcome was completeness of tumor resection via the endoscopic technique. Secondary measures were resolution of pulsatile tinnitus, audiometric outcomes, surgical duration, and surgical complications. Results: Endoscopic resection was attempted on 14 middle ear paragangliomas. Thirteen patients (93%) were women with a mean age of 61.6 years. The mean tumor size was 6.2 mm (SD, 3.3). Eleven cases (79%) had complete resection via an exclusive endoscopic approach. The mean surgical duration was 108.1 minutes (SD, 55.6). One case required use of an operating microscope via a transcanal route and two cases required postauricular incisions with mastoidectomy. There were no significant postoperative complications. Two patients (14%) had tympanic membrane perforations repaired intraoperatively without residual perforation on follow-up. All patients had normal postoperative facial nerve function. Pulsatile tinnitus resolved after surgery in all 13 patients who presented with this symptom preoperatively. The mean pure-tone average improved by 5.9 dB (SD, 4.6) after surgery. Conclusions: Endoscopic management of middle ear paraganglioma is safe, feasible, and effective.

Original languageEnglish (US)
Pages (from-to)408-415
Number of pages8
JournalOtology and Neurotology
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Paraganglioma
Middle Ear
Tinnitus
Glomus Tympanicum
Neoplasms
Tympanic Membrane Perforation
Facial Nerve
Outcome Assessment (Health Care)
Safety

Keywords

  • Endoscopic
  • Glomus tympanicum
  • Middle ear tumor
  • Paraganglioma
  • Pulsatile tinnitus

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Endoscopic Management of Middle Ear Paragangliomas : A Case Series. / Killeen, Daniel E.; Wick, Cameron C.; Hunter, Jacob B.; Rivas, Alejandro; Wanna, George B.; Nogueira, João Flávio; Kutz, Joe Walter; Isaacson, Brandon.

In: Otology and Neurotology, Vol. 38, No. 3, 01.03.2017, p. 408-415.

Research output: Contribution to journalArticle

Killeen, Daniel E. ; Wick, Cameron C. ; Hunter, Jacob B. ; Rivas, Alejandro ; Wanna, George B. ; Nogueira, João Flávio ; Kutz, Joe Walter ; Isaacson, Brandon. / Endoscopic Management of Middle Ear Paragangliomas : A Case Series. In: Otology and Neurotology. 2017 ; Vol. 38, No. 3. pp. 408-415.
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