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Paragangliome im Kopf-/Halsbereich

Teil 2: Therapie und Nachsorge

Paragangliomas of the head and neck

Part 2: Therapy and follow-up

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Abstract

Paragangliome im Kopf-/Halsbereich werden bevorzugt chirurgisch saniert. Die operative Zugangsplanung temporal gelegener Paragangliome erfolgt nach der Tumorstadieneinteilung nach Fisch. Kleinere temporale Paragangliome vom Typ A und B können transtympanal oder transmastoidal chirurgisch saniert werden. Lokal fortgeschrittene Paragangliome im Kopf-/Halsbereich sind präoperativ zu embolisieren. Zusätzlich sollte in diesen Fällen die Möglichkeit einer Resektion der A. carotis interna mit einem Okklusionstest geprüft werden. Temporale Paragangliome vom Typ C und D lassen sich über verschiedene infratemporale Zugangswege entfernen. Alternativ ist es bei einigen temporalen Paragangliomen vom Typ C1,2 und De,i1,2 günstiger, sie über unterschiedliche Varianten eines juxtakondylären Zugangswegs zu resezieren. Glomus-caroticum-Tumoren werden transzervikal entfernt. Bei operativen Kontraindikationen oder in Palliativsituationen ist eine Strahlentherapie angezeigt.

Abstract

Paragangliomas of the head and neck are preferably treated surgically. Planning the surgical approach for temporal bone paragangliomas is performed according to the Fisch classification. Small temporal paragangliomas can be removed in a transtympanic or transmastoidal procedure. Locally advanced paragangliomas of the head and neck have to be embolized presurgically. An occlusion test is also recommended to check the possibility of a resection of the internal carotid artery. Type C and D temporal bone paragangliomas can be removed by different infratemporal approaches. Alternatively, some type C1,2 and De,i1,2 temporal bone paragangliomas can be removed via variations of the juxtacondylar approach. Glomus caroticum tumors are resected transcervically. In cases of contraindications for surgery or in palliative situations radiotherapy is recommended.

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Authors and Affiliations

  1. Universitätsklinik für Hals-Nasen-Ohren-Heilkunde und Poliklinik des Universitätsklinikum Freiburg, Germany

    J. Schipper, C. C. Boedeker & W. Maier

  2. Abteilung Nephrologie der Medizinischen Universitätsklinik Freiburg, Germany

    H. P. H. Neumann

  3. Universitätsklinik für Hals-Nasen-Ohren-Heilkunde und Poliklinik des Universitätsklinikum Freiburg, Killianstraße 5, 79106 , Freiburg, Germany

    J. Schipper

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  1. J. Schipper
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  2. C. C. Boedeker
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  3. W. Maier
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  4. H. P. H. Neumann
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Correspondence to J. Schipper.

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Schipper, J., Boedeker, C.C., Maier, W. et al. Paragangliome im Kopf-/Halsbereich. HNO 52, 651–662 (2004). https://doi.org/10.1007/s00106-003-1006-8

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  • DOI: https://doi.org/10.1007/s00106-003-1006-8

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