The ideal surgical treatment for glomus jugulare tumors is total removal. Efforts have been made periodically to accomplish this since shortly after this tumor was first identified in the early 1940's. This paper describes a method of removal using a combined approach through the neck and temporal bone, preceded by a course of preoperative irradiation therapy. The early results that have been obtained using this procedure in 10 patients are reported.

An approach to tumors of the middle compartment of the skull base is described with three case reports. It is accomplished by extending the subtotal maxillectomy or maxillotomy to include removal of a part of the malar bone, coronoid process of the mandible, nasal turbinates, ethmoid and sphenoid sinuses, posterior nasal septum, and pterygoid plates. Extension of the incision through the anterior tonsillar pillar and lateral pharyngeal wall into the retropharyngeal space will assist to expose the craniocervical region from the sphenoid roof to the fifth cervical vertebra and the skull base between each eustachian tube and carotid canal. The function of the trigeminal, facial, and hypoglossal nerves, hearing, and nasal airway are preserved without mastoidectomy. A temporalis muscle flap closes the defect. Dysphagia and aspiration are not handicaps.

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Total en bloc removal is the ideal surgical treatment for glomus jugulare tumours. Efforts to accomplish this have been made periodically since shortly after this tumour was first identified in the early 1940s. A method of removal using a combined approach through the neck and temporal bone is described here. This method is preceded by pre-operative irradiation therapy and on occasion by embolization. The early results obtained using this method in 19 patients are reported.