Glomus jugulare tumours—combined treatment: Part I

Abstract

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.

Embolization in otolaryngology

“…Conventional treatment has been surgery and/or radiotherapy but embolization now provides an alternative treatment. It may be used as the definitive treatment where the tumour is large and only palliation is indicated (Hekster et al, 1973), but it can also be used in conjunction with surgery to reduce the vascularity (Simpson et al, 1979;Gardner et al, 1981), or with radiotherapy (Fig. 3).…”

Function‐preserving therapy for jugulotympanic paragangliomas: A retrospective analysis from 2000 to 2010

“…Alternative primary treatment options, depending on the individual situation (e.g., age, comorbidity, multifocal lesions, and risk of injury to cranial nerves [CNs]), include SRT (50–60 Gy) or radiosurgical procedures such as the gamma knife or CyberKnife (Accuray, Sunnyvale, CA) (12–18 Gy) 8, 9. The complex anatomy of the skull base and the highly vascularized nature of these tumors are a serious challenge for surgeons even today, although the further development of microsurgical operating techniques has also made complete removal of large JTPs possible 10–13. Various surgical access routes have been described in the literature, such as the widely used infratemporal access route pioneered by Fisch et al7, 14–20…”

Section IV. Radiation Therapy of Glomus Jugulare Tumors

“…Twenty-four commonly cited series from 1964 through 1987 provide the data on 582 patients for this review.1-25 (Gardner's series is in two parts. 18,19) Most report on the effects of both radiation and surgery, although a few are limited to a single treatment modality. The largest series in this group was that of Ogura et az.13 (72 patients); and the largest series of patients treated in a uniform fashion (surgery) comprised 49 patients (Ogura,et al 13 ).…”

“…Only two12,11 used formal staging systems,26 and in only five others were detailed data on tumor extent available. 7,11,18,23,24 In the remainder of these reports, staging information ranged from a general list of involved sites (not correlated with failures or successes) to a total lack of staging information. Some reports27,28 did not clearly distinguish between chemodectomas of different locations (i.e., tympanicum vs. jugulare) and were not included in this analysis.…”