Präoperative Embolisation mit chirurgischer Resektion von Glomustumoren im Kopf-Hals-Bereich: Analyse der klinischen Ergebnisse

Abstract

The effectiveness and safety of angiographic embolization was investigated as a preliminary step prior to surgical excision of glomus tumours in the head and neck region. Embolization was performed in 54 patients presenting with a total of 58 chemodectomas, jugular (n=30), tympanicum (n=24) and caroticum (n=4) between the years 1988 and 2006. Embolization was considered successful if complete occlusion of all tumor-feeding vessels was achieved. The procedure was performed using polyvinylalcohol particles and microcoils and lasted for a median duration of 159 minutes. Complete tumor embolization was achieved in 72 % of patients. In 23%, it was partly successful and in 4% it was unsuccessful. 16% of patients experienced minor events during the procedure including hypotension, bradycardia, and vertigo. Following embolization, almost all patients (98%) had their tumour completely excised. Although the majority experienced minor postoperative complications (69%), one patient developed meningitis. There were no reported deaths. Angiographic embolization of glomus tumours in the head and neck before definitive excision can be safe and effective, resulting in an improved surgical outcome and tumour resectability.

Stereotactic radiosurgery for the treatment of Glomus Jugulare Tumors

“…The therapeutic options for GJT treatment include surgery, radiotherapy and embolization, which can be used combined or individually. [1234567891023242526272829] Their management should also take into account two important aspects. The first is that most patients have benign, very slow-growing tumors, although malignancy can occur infrequently.…”

“…Embolization is a merely palliative treatment option due to the noncomplete coverage of the tumor volume and to the high rates of recanalization. [1011]…”

“…The rate of complications is relatively low (0-10%) and these include osteonecrosis of the temporal bone, mastoiditis, and alopecia. [310132129364243]…”

Letter to: Gastric Glomus Tumor: Report of a Case

“…The purpose of preoperative selective arterial embolization is to reduce intraoperative haemorrhage and clouding of blood over the operative field which may impair visualisation of adjacent structures, to enable a cleaner surgical field 3 . Another benefit would be to shrink up to 30% of the tumour size, which will improve its resectability 4 .…”