Conservation surgery for glomus jugulare tumors: The value of early diagnosis

Abstract

The results of‐lateral cranial base surgery for glomus jugulare tumors are gratifying when normal anatomy and function can be preserved. The goal of conservation surgery is to preserve normal ear anatomy and cranial nerve function. In general, conservation surgery is tumor‐size dependent. Thus, excellent states of functional recovery depend upon accurate early diagnosis. This paper reviews the technical aspects of transtemporal conservation skull base tumor surgery while also reviewing our experience with nearly 100 glomus jugulare patients. Adjuvants to early diagnosis will be highlighted from a review of presenting symptoms, clinical signs, and related diagnosis. Our objective is to provoke a high index of suspicion in physicians charged with the responsibility of diagnosing these tumors. Diagnostic guidelines are proposed.

Comparison of radiosurgery and conventional surgery for the treatment of glomus jugulare tumors

“…21,22,36 In one series, 24 complete removal of a glomus jugulare tumor without cranial nerve resection or a new deficit occurred in 31% of patients. Cranial nerve preservation was most easily accomplished in smaller tumors and was as high as 80 to 95%.…”

Removal of Selected Infralabyrinthine Lesions Without Facial Nerve Mobilization

“…Because it was a Fisch class Cl tumor, the lesion could probably have been completely removed by transposing the facial nerve in its mastoid portion only, as in the technique described by Jackson et al 7 Nevertheless, the patient was 59 years old and we preferred to leave a small part of this slow-growing tumor rather than to risk a facial palsy.…”

Commentary: Complex tumors of the glomus jugulare: criteria, treatment, and outcome.

“…13,29,30,64,65 Although this finding has been exploited by the proponents of radiation therapy, 10,16,60 in patients with giant tumors the lower cranial nerves are already seriously affected. 13,29,30,64,65 Although this finding has been exploited by the proponents of radiation therapy, 10,16,60 in patients with giant tumors the lower cranial nerves are already seriously affected.…”