Glomus Jugulare Tumors: A Series of 24 Cases

Abstract

Objective: Describe the surgical technique and experience of a neurotology surgical team working in Lisbon, Portugal, in the surgical treatment of glomus jugulare tumors. Method: The retrospective study included 24 patients operated between 1988 and 2007. Data were obtained from the medical records and after a recent evaluation of the patients. The outcome measures were: clinical manifestations, preoperative embolization and surgical technique, tumor removal, morbidity, mortality, and evolution of residual lesions. Results: Symptoms included hearing loss (33%); pulsatile tinnitus (21%); and cranial nerves X (29%), VII (25%), and XII (21%) paralysis. Preoperative embolization was performed in 92% of the cases, and the surgical technique was the infratemporal fossa aproach type A in all the cases. Total removal of the tumor was obtained in 11 (45%) cases. Only 21% of the patients had a grade III-IV House-Brackmann or worse after 12 months. Two patients died from pneumonia. Five (21%) of the patients required a second surgery, but only one patient required radiotherapy after incomplete removal of the tumor. Conclusion: Glomus jugulare tumors and their treatment have significant morbidity and mortality. Neurotology surgical teams should be created to develop surgical expertise and competence in the treatment of the disease in order to offer the best options to these patients.