Tympanojugular Paraganglioma with Collet–Sicard Syndrome: Importance of Radiological Investigations in Prompt Diagnosis and Management

Abstract Tympanojugular paragangliomas arise from the paraganglia of the adventitia of the jugular bulb. These tumors present a challenge for the treating surgeon because of their vascularity and involvement of important neurovascular structures, such as the internal carotid artery (ICA), the jugular bulb, the facial nerve (FN), and the lower cranial nerves (CN IX, X, XI, XII). Because of their slow and silent growth, patients often present late once they have developed complications such as multiple lower cranial nerve palsies or even intracranial extension. We report a case of tympanojugular paraganglioma with Collet–Sicard Syndrome in a 57-year-old male patient who presented to our OPD with a 2-month history of hoarseness of voice associated with cough. He has had pulsatile tinnitus in his right ear for the past 1 year and features of multiple lower cranial nerve palsies. A diagnosis of tympanojugular paraganglioma was made based on radiological investigations. Surgery was planned based on the stage of the disease, but the patient was not keen to get operated on despite counseling about the need for surgery and further management.