OUR SURGICAL APPROACHES IN GLOMUS TUMORS

¹Selçuk Üniversitesi Tıp Fakültesi, KBB AD, Konya, Türkiye
²Selçuk Üniversitesi Tıp Fakültesi, Nöroşirürji, Konya, Türkiye Objectives: To present our results in glomus tumor surgery and evaluate the results.
Patients and Methods: Twelve cases with glomus tumor were in this study. Preoperatively, all cases were evaluated with audiometric tests (pure-tone audiogram, acoustic impedance), MRI and/or CT, and angiography. Whereas infratemporal fossa type A approach was used for glomus jugulare tumors, transmastoid approach was performed in glomus tympanicum tumors. One case, in which a subtotal resection could be performed, received postoperative radiotherapy in an effort to treat the residual mass.
Results: Eight of the cases were female and four of them were male. The avarege age was 54.3. The diagnosis was glomus jugulare in eight cases and glomus tympanicum in four cases. Pulsatile tinnitus, conductive hearing loss and aural fullness were the most common presenting symptoms. In the preoperative period, there were at least three cranial nerve paralyses in each patient. Urine vanyl mandaleic acide levels were in normal limits in all cases. Whereas all glomus tympanicum tumors were resected completely, this rate was 87.5 % for glomus jugulare tumors. In one case with intracranial extension and internal carotid artery invasion, subtotal resection could be performed; for that reason postoperative radioterapy was used in order to treat the residual mass. Postroperatively, temporary facial nerve paralysis occured in all glomus jugulare cases in which the tumors were resected via infratemporal fossa type A approach. There were no changes for the other cranial nerve paralysis postoperatively. As a further complication, there was one case of a cerebro spinal fluid fistula. There were no recurrences in the totally resected cases during the follow up period which was 54 months (11-116 months) in average. There were no peri or postoperative deaths.
Conclusion: The results of our study indicated that glomus tympanicum and glomus jugulare tumors can be resected via the transmastoid and infratemporal fossa type A approaches with minimal morbidity and mortality rates. Keywords : Glomus jugulare, glomus tympanicum, surgery