{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:23:05Z","timestamp":1784326985032,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T00:00:00Z","timestamp":1583193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide the first description of hypofractionated stereotactic radiosurgery (SRS) and evaluate tumor control and safety for vagal paragangliomas (VPs), which begin at the skull base but often have significant extracranial extension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary\u2010referral neurotology and neurosurgery practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Five VPs in 4 patients (all male, ages 15\u201056 years) underwent SRS between 2010 and 2018. Outcome measures included tumor dimensions on serial imaging, cranial nerve function, and radiation side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CyberKnife hypofractionated SRS was performed. The prescription dose was 24 or 27\u00a0Gy (maximum dose 33.4\u00a0Gy; range, 29.3\u201035.5\u00a0Gy) delivered in 3 equal fractions. The mean isodose line was 79% (range, 76%\u201082%). Four VPs were treated primarily, and 1 tumor underwent SRS to treat regrowth 2 years after microsurgical subtotal resection via the modified infratemporal fossa approach. The treatment volume ranged from 8.81 to 86.3\u00a0cm<jats:sup>3<\/jats:sup> (mean, 35.7\u00a0cm<jats:sup>3<\/jats:sup>). All demonstrated stable size (n = 3) or regression (n = 2) at last follow\u2010up, 63 to 85\u00a0months after SRS (mean, 76\u00a0months). One patient had stable premorbid vocal fold paralysis from a prior ipsilateral glomus jugulare tumor resection. All others demonstrated normal vagal function following SRS. Treatment\u2010related side effects, including dysgeusia (n = 1), mucositis (n = 1), and neck soft\u2010tissue edema (n = 2), were self\u2010limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hypofractionated SRS appears to be both safe and effective for treating VPs, including large\u2010volume and predominantly extracranial tumors, while preserving vagal function. SRS should be considered as a cranial nerve preservation option, especially in settings of contralateral lower cranial nerve deficits or in those with multiple paragangliomas risking both vagal nerves.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820910150","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T13:36:57Z","timestamp":1583242617000},"page":"897-904","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hypofractionated Robotic Stereotactic Radiosurgery for Vagal Paragangliomas: A Novel Treatment Strategy for Cranial Nerve Preservation"],"prefix":"10.1002","volume":"162","author":[{"given":"Anne K.","family":"Maxwell","sequence":"first","affiliation":[{"name":"House Ear Institute Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam U.","family":"Mehta","sequence":"additional","affiliation":[{"name":"House Ear Institute Los 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