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Successful Return of Function after Paraganglioma with Vagal Resection: A Case Report
Kylee J Yturralde, BS1; Victoria Stowasser, BS1; Riley J Schlub, MD2; Carlos R Martinez, MD, MPH2; Harold I Friedman, MD, PhD3; Mariangela Rivera, MD4; Mirsad M Mujadzic, MD2
1University of South Carolina School of Medicine- Columbia, Columbia, SC; 2University of South Carolina, Columbia, SC; 3Prisma Health, Columbia, SC; 4Prisma Health, Greenville, SC

Introduction: Vagal paragangliomas are rare tumors originating from neural crest cells. Management options range from surgery, radiation, and expectant management because of high after resection. Most of the previous reports of paraganglioma of Vagus Nerve were treated with resection without reconstruction. To our knowledge, we did not identify reports of Vagus nerve reconstruction after paraganglioma resection in the English literature. We present a successful reconstruction of a Vagus nerve after tumor excision resulting in a functional return of vocal cords.
Methods: A 40-year-old previously healthy male presented with a Vagal Paraganglioma that ultimately was resected. The ansa cervicalis and greater auricular nerves were donor grafts for interposition cable grafting. The patient had follow-up at 3-, 6- and 12-month intervals. At the 12-month interval he underwent flexible endoscopy.
Results: At 3 and 6-month follow-up, patient had continued vocal paresis but progressively improved speech. At 12-month follow-up, flexible endoscopy demonstrated a returned capacity for vocal cord adduction and resolution of speech symptoms.
Conclusions: Vagus nerve paragangliomas are rare tumors that occur in an estimated 1 in 100,000 individuals. Our patient had a successful return of his vocal cord function after paraganglioma resection and cable grafting. We hope that more surgeons will consider grafting Vagus nerve defects in the future.


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