Objectives Paragangliomas of the lateral skull base are rare, largely benign, neuroendocrine tumors. Little evidence exists to support clinicians in the management of these tumors. The present study evaluates considerations in the multidisciplinary workup and management of paragangliomas affecting the lateral skull base.

Methods A STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist compliant retrospective review of adult patients with lateral skull base paragangliomas over 20 years (2002–2021) was performed. Patient and tumor data were collected from patient health care records.

Results Seventy patients were identified including 21 (30.0%) males and 49 (70.0%) females. The mean length of follow-up was 87.3 months (range: 12–239 months). Twenty-nine (41.4%) patients had Fisch A or B tumors. Overall, 57 patients (81.4%) were offered treatment upfront, with 13 patients (18.6%) initially undergoing active surveillance. Younger age and reduced American Society of Anesthesiologists (ASA) grade was significantly associated with a decision to offer treatment at presentation (both p = 0.03), while all patients with succinate dehydrogenase (SDH) mutations (n = 10) and tumor secretion (n = 4) were offered treatment. Patients with Fisch A/B tumors (p = 0.01), cranial neuropathies (p = 0.01), and smaller tumors (p = 0.01) were more likely to undergo surgical resection. At the time of the last follow-up, the proportion of patients with a cranial neuropathy was notably lower in the observation (3/12, 25.0%) and radiotherapy (1/6, 16.7%) groups.

Conclusions In our series, younger, fitter patients with SDH mutations, cranial neuropathies, or tumor secretion were more likely to be offered upfront treatment. There was a low incidence of new cranial neuropathy in the patients selected for observation during long-term follow-up.

目的 侧颅底副神经节瘤是罕见的，大部分是良性的神经内分泌肿瘤。几乎没有证据支持临床医生治疗这些肿瘤。本研究评估了影响侧颅底的副神经节瘤的多学科检查和治疗中的考虑因素。

方法 对 20 多年（2002-2021 年）的侧颅底副神经节瘤成年患者进行符合流行病学观察研究报告（STROBE）清单的回顾性审查。从患者的医疗保健记录中收集患者和肿瘤数据。

结果 共确诊70例患者，其中男性21例（30.0%），女性49例（70.0%）。平均随访时间为 87.3 个月（范围：12-239 个月）。二十九名 (41.4%) 患者患有 Fisch A 型或 B 型肿瘤。总体而言，57 名患者 (81.4%) 接受了预先治疗，其中 13 名患者 (18.6%) 最初接受了主动监测。年龄较小和美国麻醉医师协会 (ASA) 等级降低与就诊时提供治疗的决定显着相关（均p  = 0.03），而所有具有琥珀酸脱氢酶 (SDH) 突变 ( n  = 10) 和肿瘤分泌 ( n)的患者 = 4) 接受治疗。患有 Fisch A/B 肿瘤 ( p  = 0.01)、颅神经病变 ( p = 0.01），较小的肿瘤（p  = 0.01）更有可能接受手术切除。末次随访时，观察组（3/12，25.0%）和放疗组（1/6，16.7%）出现颅神经病变的患者比例明显较低。

结论 在我们的系列中，患有 SDH 突变、颅神经病变或肿瘤分泌的年轻、健康的患者更有可能接受前期治疗。在长期随访期间选择观察的患者中新发颅神经病变的发生率较低。