Fisch Classification of Jugulotympanic Paragangliomas

• The Fisch Classification system is a classification scheme for jugulotympanic paragangliomas.¹²
  • One of 2 commonly used classification schemes for jugulotympanic paragangliomas, the other being the Glasscock-Jackson Classification Scheme.³
• Fisch’s original classification scheme (1979) divided glomus tumours into 4 types:
  • Type A: glomus tympanicum tumour
  • Type B: glomus jugulare with no bony destruction
  • Type C: glomus jugulare tumour with destruction of the infralabyrinthine component of the temporal bone
  • Type D: glomus jugulare with intracranial extension.
• Fisch then updated his classification scheme in 1982 with further subclassifications for Type C and D for improved precision.
• Fisch Classification:
  • Class A: Glomus tympanicum tumour.
  • Class B: Glomus jugulare tumour with no bony destruction.
  • Class C: Glomus jugulare tumours with destruction of the infralabyrinthine compartment of the temporal bone.
    • C1: Tumours with limited involvement of the vertical portion of the carotid canal.
    • C2: Tumours involving the vertical portion of the carotid canal
    • C3: Tumours involving the horizontal portion of the carotid canal
  • Class D: Glomus jugulare tumours with intracranial extension.
    • D1: Intradural extension of <2 cm
    • D2: Intradural extension of >2 cm
    • D3: Neurologically unresectable tumours.

Fisch Classification (1982)