Diagnosis and Treatment of Tympanic Paraganglioma

ZHAO Yuli; NAN Shuling; LIU Beibei; CHEN Chi; LIU Xiaowen; DUAN Shihong; XU Baicheng

doi:10.3969/j.issn.1672-2922.2024.01.015

Abstract：Objective To report clinical features of tympanic paraganglioma and authors'experience with its di-agnosis and treatment.Methods Data from 15 patients(3 males and 12 females)with pathologically confirmed tympan-ic paraganglioma were retrospectively reviewed.The tumor was on the left in 8 cases,on the right in 6 case,and on both sides in 1 case.Potential problems in diagnosis and surgical indications and techniques were discussed.Results Tinni-tus(100%),hearing loss(93.3%)and ear discharge(86.7%)were the main symptoms.Red mass in the external auditory canal was seen in 11 of the 16 ears,with pulsation in 6 ears and red pulsatile mass behind the tympanic membrane in 5 ears.Hearing was normal in 2 cases,showing conductive deafness in 6 cases and mixed deafness in 7 cases.All patients underwent HRCT and five patients also underwent MRI.Tympanic paraganglioma were diagnosed clinically in 10 cas-es.In 5 cases it was misdiagnosed as chronic suppurative otitis media and cholesteatoma of external auditory canal.Ac-cording to the Fisch classification,the lesion was type A in 2 case and type B in 13 cases(14 ears).All tumors were completely surgically resected with no recurrence during the 1-5 years follow-ups.Conclusion Tympanic paraganglio-ma is a rare disease,but should be suspected in a middle-aged women with tinnitus,hearing loss,red mass in the exter-nal auditory canal or behind the tympanic membrane.HRCT and enhanced MRI are beneficial in diagnosis.Surgical re-moval is effective,with microscopic approach being the mainstream for middle ear paraganglioma.With the develop-ment of technology,resection via a transcanal endoscopic approach starts to show certain application prospects in the fu-ture.