New perspectives in Skull Base Paraganglioma with Stenting of Internal Carotid Artery

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Enrico Piccirillo

Gruppo Otologico Piacenza-Roma. Italy

: J Otol Rhinol

Abstract

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BACKGROUND: The purpose of this study was to share our review of surgical strategies and long-term outcomes in the management of tympanojugular paragangliomas (TJPs). Management of the cervical and petrous internal carotid artery (ICA) is frequently required in Fisch class C tympanojugular paragangliomas. The purpose of this study was to discuss the perioperative intervention of the ICA in patients who underwent surgical resection of a TJP. METHODS: A retrospective study of 237 patients surgically treated for Fisch class CTJPs was done to identify cases that required ICA management. RESULTS: Management of the ICA was required in 176 patients (74.2%). Forty-two patients required just an ICA decompression, 88 underwent a subperiosteal dissection, 19 underwent subadventitial dissection without intraluminal stenting, 17 underwent subadventitial dissection with intraluminal stenting, and 12 underwent arterial resection after permanent balloon occlusion. There were no complications associated with the endovascular procedures. Gross total tumor resection was achieved in 91.5% of the cases. CONCLUSION: A thorough understanding of skull base techniques and a logical decision-making process in the management of tympanojugular paragangliomas can achieve a high rate of success in terms of recurrences and complications. Preoperative endovascular intervention, in selected cases, facilitates gross total tumor removal and significantly reduces the risk of an intraoperative ICA injury.

Biography

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Enrico Piccirillo has done Bachelor of Medicine and Surgery , University “La Sapienza” of Roma on 31.10 1990 (110/110 cum laude).Specialization in ENT and Facial Cervical Diseases University “La Sapienza di Roma" Attended four years course on " Facial Cervical Tumors" (1993-1996) - Istituto dei Tumori di Milano. From 1998 till now, member of the Gruppo Otologico Piacenza and Roma (Italy) Large experience in Middle Ear Surgery, Skull Base Surgery and Nose and Paranasal Sinuses with Endoscopic Approaches. Italian Licence of Professorship in Otorhinolaryngology (MIUR- 2015).