Tympanojugular paragangliomas. Two case reports

Introduction. Paragangliomas are benign tumours that arise from the paraganglionic system. The most frequently encountered symptoms of tympanojugular paragangliomas are pulsatile tinnitus and conductive hearing loss. High resolution computed tomography, with reconstruction in axial and coronal planes, is mandatory in every suspected case of tympanojugular paraganglioma. The treatment is guided by the classification of Fish. Cases presentation. We present two cases in whom the clinical manifestations and paraclinical investigations established the diagnosis of tympanojugular paraganglioma. Both surgery and postoperative evolution are described for each case. In most of these tumours, surgery remains the mainstay treatment. According to the preoperative plan of the first case, it was decided that the tumour can be resected safely, without compromising the cranial nerves. In the second case, the entire tumour was removed, but with the sacrifice of the inferior cranial nerve, caught in the tumour mass. Conclusions. These tumours have the tendency to involve multiple vital structures of the skull base. A detailed preoperative plan of treatment is required to maximize tumour resection, while minimizing morbidity of the great vessels and lower cranial nerves.