Article
12 cases of glomus jugulare tumors
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Published: | May 20, 2009 |
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Objective: Glomus jugulare tumors are rare benign, slow-growing tumors. Nevertheless, they can provoke severe neurological deficits due to their localization. Without any treatment their 10- years-mortality rate ranges up to 35%. Radical resection is proven to be the only efficient treatment.
Methods: From 1997 to 2007 12 patients (10 female, 2 male) suffering from glomus jugulare tumors were treated by a cooperating team of neurosurgeons and ENT-surgeons. The patients´ age ranged from 31 to 65 years (mean age 47 years). All of them were preoperatively analyzed by neurologists and ENT-specialists. MRT and CT revealed bone destruction and the expansion of the tumor mass. The Fisch and Valavanis-gradation ranged from C1 to C3 and D1-D2. Preoperative embolization was always done to occlude feeding vessels.
Results: After preoperative embolization 3 patients suffered from transient hemiplegia and aphasia, but in all cases surgery could be performed within 4 days. In 11 cases the tumor mass was completely removed, in one case subtotal resection was carried out. One recurrence was observed. It has to be pointed out that there were 4 patients with their initial operation done in another hospital. Follow-up examination detected 6 cases of anacusis (5 patients already suffered from hypoacusis before surgery). Tinnitus improved in 5 cases. Most commonly palsy of the facial and caudal cranial nerves were seen. In 3 cases the facial nerve was resected because of infiltration by the tumor. In a second stage the facial nerve was restored using auricularis magnus nerve graft. However, since only one patient developed satisfactorymimic function, the others were forwarded to facial muscle transfer. In 3 cases the facial nerve could be preserved and was therefore only decompressed. These patients developed transient palsy recovering within the next 12 months. In 6 out of 8 cases postoperative dysphagia recovered slightly.