Paragangliomas are rare tumours within the head and neck and any article which succinctly jogs the memory with respect to their existence and subsequent accurate diagnosis is welcome. This article concisely explains the imaging techniques used to diagnose these tumours as histological confirmation is not usually feasible, given their vascular nature. The appearances of the different types (carotid, vagale, jugulare and tympanicum) are outlined for each of the modalities (CT and MRI) with images to accompany the descriptions. Digital subtraction angiography is described as a technique used pre-embolisation in the larger tumours and the dominating vessels that should be targeted for embolisation preoperatively, usually the ascending pharyngeal for most of them. The authors then go on to describe in detail the technique of the balloon occlusion test (to be performed if the carotid or vertebral artery is expected to be resected). This ensures adequate collateral cerebral circulation to avoid serious cerebral ischaemia. They also describe in detail the embolisation procedure which is an interesting read for surgeons who do not often venture into the interventional theatres. Appreciating the procedures these patients undergo prior to their surgical resection undoubtedly assists in providing helpful information to them for their patient journey. 

Paraganglioma — Role of preoperative evaluation and endovascular embolization.
Paramasivamc S, Persky MJ, Berenstein A.
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Suzanne Jervis

FRCS (ORL HNS), Shrewsbury and Telford Hospitals, NHS Trust, UK.

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