Lateral Skull Base Surgery for Glomus Tumors: Long-Term Control

Jackson, C. Gary; McGrew, Benjamin M.; Forest, John A.; Netterville, James L.; Hampf, C F; Glasscock, Michael E.

doi:10.1097/00129492-200105000-00018

Cited by 122 publications

(156 citation statements)

References 11 publications

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“…This is consistent with the rates of deficits reported in other series. In the one reported by Jackson et al, 16 new deficits were found in CNs IX, X, XI, and XII in 39%, 25%, 26%, and 21% of cases, respectively.…”

Section: Discussionmentioning

confidence: 68%

“…25 Surgical approaches are challenging because of the proximity of critical vascular and neural structures that are frequently invaded by the tumor. 1,18 Jackson and colleagues 16 reviewed 18 cases of incompletely resected tumors and found that 9 of them had progressed to the point that they required further interventions.…”

Section: Discussionmentioning

confidence: 99%

“…23 Furthermore, significant morbidity and reduced quality of life are common downsides of surgical therapy, 11,14,16,23 with 50% of patients experiencing permanent lower cranial nerve palsies after surgery. 23 Finally, it should also be acknowledged that, according to recent publications, surgery carries a mortality rate of about 4%.…”

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confidence: 99%

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Jugulotympanic paragangliomas treated with Gamma Knife radiosurgery: a single-center review of 58 cases

Gandía-González

Kusak

Moreno

et al. 2014

JNS

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Object Jugulotympanic paragangliomas (JTPs) are rare benign tumors whose surgical treatment is usually associated with partial resection of the lesion, high morbidity, and even death. Gamma Knife radiosurgery (GKRS) has been reported as a useful treatment option. The goal of this retrospective study is to analyze the role of GKRS in tumor volume control and clinical outcomes of these patients. Methods A total of 75 patients with JTPs were treated with GKRS at the authors' center from 1995 to 2012. The authors analyzed those treated during this period to allow for a minimal observation time of 2 years. The MR images and clinical reports of these patients were reviewed to assess clinical and volumetric outcomes of the tumors. The radiological and clinical assessments, along with a group of prognostic factors measured, were analyzed using descriptive methods. The time to volumetric and clinical progression was analyzed using the Kaplan-Meier method. Prognostic factors were identified using log-rank statistics and multivariate Cox regression models. Results The mean follow-up was 86.4 months. The authors observed volumetric tumor control in 94.8% of cases. In 67.2% of cases, tumor volume decreased by a mean of 40.1% from the original size. Of patients with previous tinnitus, 54% reported complete recovery. Improvement of other symptoms was observed in 34.5% of cases. Overall, clinical control was achieved in 91.4% of cases. Previous embolization and familial history of paraganglioma were selected as significant prognostic factors for volumetric response to GKRS treatment in the univariate analysis. In multivariate analysis, no factors were significantly correlated with progression-free survival. No patient died of side effects related to GKRS treatment or tumor progression. Conclusions Gamma Knife radiosurgery is an effective, safe, and efficient therapeutic option for the treatment of these tumors as a first-line treatment or in conjunction with traditional surgery, endovascular treatment, or conventional fractionated radiotherapy.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Jugulotympanic paragangliomas treated with Gamma Knife radiosurgery: a single-center review of 58 cases

Gandía-González

Kusak

Moreno

et al. 2014

JNS

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“…4 With the advent of improved microsurgical techniques and the use of combined approaches, the mortality rate has lowered substantially; however, cranial nerve injury continues to be a problem. [18][19][20][21] In a retrospective series of 176 patients treated between 1972 and 1998 and reported by Jackson, et al, 12 in 85% complete surgical control was described. The remaining 15% of their patients had a subtotal resection or recurrence.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of stereotactic radiosurgery for glomus jugulare tumors

Lim¹,

Gibbs²,

Adler³

et al. 2004

FOC

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Object Since the mid-1990s the use of radiosurgery for glomus jugulare tumors has grown in popularity. Despite its increased use, follow-up periods for radiosurgery are short and the numbers of patients reported are small. To add to the available information, the authors report their experience with the application of linear accelerator (LINAC) or CyberKnife modalities in 13 patients with 16 tumors. Methods All patients were treated with frame-based LINAC or CyberKnife radiosurgery, with doses ranging from 1400 to 2700 cGy. Patients were retrospectively assessed for posttreatment side effects, which included hearing loss, tongue weakness, and vocal hoarseness. The patients' most recent magnetic resonance (MR) images were also assessed for changes in tumor size. The median follow-up duration was 41 months and the mean follow-up period was 60 months. All tumors remained stable or decreased in size on follow-up MR images. All patients had stable neurological symptoms, and one experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this individual had received previous external-beam radiation therapy. Conclusions The authors' findings continue to support radiosurgery as an effective and safe method of treatment for glomus jugulare tumors that results in low rates of morbidity.

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“…44 In 1987, Al-Mefty et al 1 described a combined approach for giant glomus tumors with intracranial extension, previously believed to be inoperable, again expanding the spectrum of tumors amenable to resection. The ability to achieve effective gross-total resection in the microsurgical era was illustrated in 2001 26 in one of the largest series of glomus tumors to date. In this publication, Jackson et al 26 reported on the surgical results following 182 procedures for resection of glomus tumors involving the skull base; 152 of the procedures involved jugulotympanic glomus tumors.…”

Section: Evolution In Tumor Managementmentioning

confidence: 99%