Canal wall reconstruction and conductive hearing preservation for temporal bone paraganglioma.

INTRODUCTION Paraganglioma is the most common tumor of the middle ear and jugular foramen. Surgery is the mainstay of treatment; other options include observation and stereotactic radiotherapy. The standard of care of paragangliomas involving the carotid canal is the infratemporal fossa (ITF) approach proposed by Fisch in 1977. The ITF approach provides safe access for large paraganglioma expiration; however, it classically requires middle ear obliteration and closure of the external auditory canal (EAC), with resultant maximal conductive hearing loss (CHL). A case of a 28-year-old woman with bilateral Fisch classification C3 jugular foramen paragangliomas inspired us to modify the ITF approach to limit CHL, and thus improve overall functional outcome and postsurgical quality of life.