Vasc Spec Int.  2019 Jun;35(2):105-110. 10.5758/vsi.2019.35.2.105.

Vagal Paraganglioma: Surgical Removal with Superior Laryngeal Nerve Preservation

• Kotsis T
• Christoforou P

• KMID: 2455141
• DOI: http://doi.org/10.5758/vsi.2019.35.2.105

Abstract

Vagal paragangliomas (VPGLs) represent <5% of all head and neck paragangliomas (PGLs) and show a 17% to 20% risk of malignancy. We present a rare case of a 50-year-old gender with a left VPGL in her neck. To date, approximately 200 cases have been reported. The tumor showed web-like adhesions and arterial supply from the external carotid artery. We performed en bloc resection including a part of the vagus nerve. The superior laryngeal nerve was preserved with the "human communicating nerve" which maintains neural communication in >70% of humans, providing motor fibers to the larynx. The patient recovered uneventfully and was discharged on the 3rd postoperative day. These tumors are therapeutically challenging owing to their proximity to vital neck and skull base structures. Early detection decreases surgical morbidity and mortality. Preservation of viable neural tissue is important in advanced disease.

Keyword

Vagus nerve; Paraganglioma; Vagus paraganglioma; Superior laryngeal nerve; Human communicating nerve

MeSH Terms

Carotid Artery, External
Head
Humans
Laryngeal Nerves*
Larynx
Middle Aged
Mortality
Neck
Paraganglioma*
Skull Base
Vagus Nerve