Chemodectomas of the glomus jugulare are best controlled by a combined approach where radical mastoidectomy is followed by 4500 rads external megavoltage irradiation. Postoperative radiotherapy both delays recurrences (by an average of 10 years) and reduces the frequency of recurrences. Approximately one half of all patients who were operated on but not irradiated have had recurrences. One third of all patients who had a successful operation with “complete” removal of the tumor, and who were not irradiated, have had a recurrence. One fourth of all the patients with chemodectomas who were operated on and irrradiated have had a recurrence, while none of the 16 patients with chemodectomas who received more than 4000 rads have had a recurrence. Surgery without irradiation is reserved for the infrequent patient who has a recurrence after a full course of radiation therapy, or when there is significant infection. Irradiation alone is indicated when there is extensive unresectable disease involving several cranial nerves. The patient with a chemodectoma should never be considered cured. The longer the patient is followed, the more likely is a recurrence.
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