gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

12 cases of glomus jugulare tumors

Meeting Abstract

  • M.T. Pedro - Neurochirurgische Klinik der Universität Ulm, Bezirkskrankenhaus Günzburg
  • C.R. Wirtz - Neurochirurgische Klinik der Universität Ulm, Bezirkskrankenhaus Günzburg
  • H. Riechelmann - Hals-Nasen-Ohren-Klinik, Universität Innsbruck
  • G. Antoniadis - Neurochirurgische Klinik der Universität Ulm, Bezirkskrankenhaus Günzburg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP08-06

doi: 10.3205/09dgnc334, urn:nbn:de:0183-09dgnc3343

Published: May 20, 2009

© 2009 Pedro et al.
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Outline

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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.