目的：探讨经典颞下窝A型入路改良手术治疗保留外、中耳结构的颈静脉孔副神经节瘤的可行性和效果。方法：回顾性分析2例经迷路下经乳突入路治疗颈静脉孔副神经节瘤患者的临床资料。评价患者的临床特征、肿瘤切除程度、术后面神经功能和听力保留情况以及术后并发症的发生情况。结果：2例患者均为女性，病理证实为副神经节瘤。病例1的肿瘤分期为C2De1，病例2的肿瘤分期为C1De1。两名患者的肿瘤均被完全切除。病例1术后感染，残留鼓膜穿孔，混合性耳聋。病例2术后出现轻度面瘫（Ⅱ级），经对症治疗后恢复。随访半年未见肿瘤残留或复发。结论：采用迷路下-经乳突和上颈联合入路手术治疗某些颈静脉孔副神经节瘤，可达到肿瘤完全切除的目的，同时保留中耳外层的结构和功能。该术式适用于局限于颈静脉孔区、颈内动脉（C1或C2）无或有限受累、无或轻度听力损失的副神经节瘤。版权所有©《临床耳鼻喉科杂志》编辑部颈部手术。

Objective:To investigate the feasibility and effect of the modified surgery of the classic infratemporal fossa type A approach for the surgical treatment of jugular foramen paraganglioma with preservation of the external and middle ear structures. Methods:The medical data of 2 patients with jugular foraminal paraganglioma treated by sublabyrinthic-transmastoid approach were retrospectively analyzed. The clinical feature, degree of tumor resection, postoperative facial nerve function and hearing retention, and the incidence of postoperative complications were evaluated. Results:Two patients were both female, and were pathologically confirmed as paraganglioma. The tumor of case 1 was staged as C2De1, and case 2 as C1De1. Tumors were completely resected in both patients. Case 1 suffered infection after surgery, with residual tympanic membrane perforation and mixed deafness. Case 2 developed mild facial paralysis（grade Ⅱ） after surgery, and recovered after symptomatic treatment. There was no tumor residue or recurrence during half a year of follow-up. Conclusion:Surgical treatment of certain paragangliomas in the jugular foramen with a combined sublabyrinthic-transmastoid and upper neck approach might achieve both complete resection of the tumor and preserving the structure and function of the outer-middle ear. This procedure is suitable for paragangliomas restricted in the jugular foramen area, with no or limited involvement of the internal carotid artery（C1 or C2）, and with no or mild hearing loss.Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.