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Megerian CA, McKenna MJ, Nadol JB. Non-paraganglioma jugular foramen lesions masquerading as glomus jugulare tumors. THE AMERICAN JOURNAL OF OTOLOGY 1995; 16:94-98. [PMID: 8579185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Pulsatile tinnitus, hearing loss, lower cranial nerve deficits, and radiographic evidence of a vascular lesion of the jugular foramen have been considered diagnostic of a glomus jugulare tumor. Angiographic evidence of a blood supply from the external carotid artery system, including the ascending pharyngeal artery, further substantiates this diagnosis. This diagnostic algorithm for tumors of the jugular fossa is usually followed by either a surgical exenteration of a presumed glomus jugulare tumor via an infratemporal fossa approach or radiation therapy in selected patients. Pre-treatment biopsy of such lesions is typically not done, nor is it recommended widely in the literature. As demonstrated in this report, a number of lesions, including hemangiopericytoma and extramedullary plasmacytoma presenting in the jugular foramen can mimic glomus jugulare tumors in all aspects of their clinical and radiographic presentation. Omission of a pre-treatment biopsy can lead to a treatment plan appropriate for glomus tumors but suboptimal for these rare pathologic entities. A pre-treatment biopsy of lesions of the jugular foramen by exploratory tympanotomy or postauricular mastoidotomy provides a pathologic diagnosis on which to base treatment of lesions of the jugular foramen, without adding substantial morbidity or decreasing the chances of cure.
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102
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Angeli SI, Sato Y, Gantz BJ. Glomus jugulare tumors masquerading as benign intracranial hypertension. ARCHIVES OF OTOLARYNGOLOGY--HEAD & NECK SURGERY 1994; 120:1277-80. [PMID: 7917214 DOI: 10.1001/archotol.1994.01880350083015] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Intracranial hypertension has been reported as a complication of massive glomus jugulare tumors with intracranial extension. We describe a patient with papilledema, failing vision, and a diagnosis of benign intracranial hypertension with bilateral glomus jugulare tumors that went undetected for 2 years. There was no evidence of intracranial invasion by the tumors to explain the elevation of intracranial pressure. Embolization followed by surgical removal of the left tumor resulted in stabilization of the neurologic condition and preservation of the lower cranial nerves, including intact hearing. The likely mechanism of intracranial hypertension in this case is an impairment of cerebrospinal fluid absorption. This unusual presentation should be recognized to avoid delayed diagnosis and treatment. Furthermore, intracranial hypertension is not always associated with massive intracranial tumor involvement, as had been previously proposed.
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103
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Weber AL, McKenna MJ. Radiologic evaluation of the jugular foramen. Anatomy, vascular variants, anomalies, and tumors. Neuroimaging Clin N Am 1994; 4:579-98. [PMID: 7952957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The jugular foramen varies considerably in size and shape, along with the jugular vein. The foramen is traversed by several vessels and nerves. CT, in various section planes, demonstrates the bone anatomy optimally, whereas MR (including MR angiography) reveals the vascular and soft tissue structures to best advantage. A diverse group of vascular anomalies originate in the foramen and adjacent carotid canal that must be differentiated from tumors. The most common tumor within the jugular foramen is the hypervascular glomus jugulare tumor followed by neurogenic tumors, predominantly the schwannoma. Less common lesions comprise meningioma, hemangiopericytoma, chondrosarcoma, and plasmacytoma. Metastases and malignant tumors arising in adjacent anatomic structures (nasopharynx, parotid, and temporal bone), in advanced stages, may spread to the jugular foramen. Endolymphatic sac tumors arise at the posterior medial aspect of the petrous bone and frequently extend to the jugular foramen. Irregular lytic bone destruction, with enlargement and hypervascularity, demonstrated by CT and MR imaging, are characteristic for glomus jugulare tumors. Benign tumors, most commonly the jugular foramen schwannoma, display an enlarged jugular foramen with well-defined bone margins.
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104
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Jecker P, Pau HW, Zanella W. [Differential diagnosis of bluish red tumors of the posterior intact tympanic membrane]. Laryngorhinootologie 1994; 73:363-6. [PMID: 7916780 DOI: 10.1055/s-2007-997153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Middle ear tumours may be seen frequently as bluish-red masses behind an intact tympanic membrane. In these cases all modern methods of visualisation such as CT or NMR are required for correct diagnosis and for planing adequate treatment. Most frequent are glomus tumours, either of the glomus tympanicum or the glomus jugulare. However, differential diagnosis must be considered, e.g. a tumour in the lower parts of the tympanon. In very rare cases the internal carotid artery takes an abnormal course, running free through the middle ear and touching the tympanic membrane. More often, granulomas or other inflammatory processes may be seen through a transparent ear drum. Haemangiomas or--of course--malignant tumours must be kept in mind. The role of modern radiographic methods is described in this paper, including some of the differential diagnoses mentioned above, with special reference to a case of carotid artery anomaly.
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105
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Pulec JL, Deguine C. Glomus jugulare tumor. EAR, NOSE & THROAT JOURNAL 1994; 73:213. [PMID: 8020415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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106
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Watkins LD, Mendoza N, Cheesman AD, Symon L. Glomus jugulare tumours: a review of 61 cases. Acta Neurochir (Wien) 1994; 130:66-70. [PMID: 7725944 DOI: 10.1007/bf01405504] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A retrospective study of 61 patients with glomus jugulare tumours treated at the National Hospital for Neurology and Neurosurgery, and at the Royal National Throat, Nose and Ear Hospital, London. The average age at presentation was 41.7 years. The patients were mainly treated by a posterolateral combined otoneurosurgical approach. 42/61 of the patients had total or subtotal excision of their tumours, 7/61 had partial removal and the remaining 11/61 had no operation. Only one case required a 2-staged procedure. There were two deaths in the postoperative period, one from intracerebral haemorrhage and the other from the left hemisphere infarction. Postoperative radiotherapy was given to 5/7 of the patients who had partial removal. 3/40 of the patients with total removal had postoperative radiotherapy, and a further 3/40 had received radiotherapy pre-operatively. Of the 11 patients who did not undergo surgery, 7/11 were treated with radiotherapy and 4/11 had embolisation only.
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107
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Cejas Méndez L, Fajin Halawa B, Perera A. [Presenting 2 cases of glomus tumors: tympanic and jugular]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 1994; 45:114-6. [PMID: 8086203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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108
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Mukherji SK, Kasper ME, Tart RP, Mancuso AA. Irradiated paragangliomas of the head and neck: CT and MR appearance. AJNR Am J Neuroradiol 1994; 15:357-63. [PMID: 8192086 PMCID: PMC8334618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To present the spectrum of CT and MR findings of glomus tumors of the head and neck successfully treated with radiation therapy. METHODS The patient charts and all CT and MR studies of 24 patients (25 tumors) who had been successfully treated with radiation therapy were retrospectively reviewed. Eighteen patients had pre- and posttreatment imaging studies. Tumor size, internal morphology, enhancement pattern, visualization of flow voids, and bone erosion were evaluated before and after radiation therapy. Statistical evaluation of the presence of flows voids and tumor size was performed using the Fischer Exact Test. RESULTS All patients had residual tumor after radiation therapy. Sixty-one percent of tumors demonstrated a reduction in size. Only one tumor with pretreatment bone destruction demonstrated healing of the bone. MR findings after radiation therapy included variable alteration in T2 signal, decreased heterogeneous enhancement, and a reduction in flow voids. There was a significant difference in the presence of flow voids based on tumor size. CONCLUSIONS Successfully irradiated paragangliomas demonstrate residual masses, the presence of which does not by itself indicate treatment failure. Stabilization or reduction in size, decreased enhancement, diminished flow voids, and reduced T2 signal after radiation therapy are a result of therapy and are indicative of local control. Persistent bone demineralization and erosion without progression is commonly seen in successfully controlled tumors. Paragangliomas are relatively homogeneous in internal morphology except for areas of flow void. Flow voids are not a reliable criterion for diagnosis in lesions less than 2.5 cm.
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109
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Moffat DA, Saunders JE, McElveen JT, McFerran DJ, Hardy DG. Unusual cerebello-pontine angle tumours. J Laryngol Otol 1993; 107:1087-98. [PMID: 8288995 DOI: 10.1017/s0022215100125393] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Fifty-nine unusual cerebello-pontine angle tumours have been studied. These lesions represent 19.3 per cent or 1 in 5 of a series of 305 cerebello-pontine angle tumours of which the rest, 246 (80.7 per cent), were acoustic neuromas. An analysis of the relative incidence, histology and presenting clinical features has been carried out. The various radiographical features and imaging techniques used to diagnose these fascinating tumours have been described and also the otoneurosurgical procedures necessary to excise them.
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110
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Jackson CG. Neurotologic skull base surgery for glomus tumors. Diagnosis for treatment planning and treatment options. Laryngoscope 1993; 103:17-22. [PMID: 8231589 DOI: 10.1002/lary.1993.103.s60.17] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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111
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Athanassopoulou AC, Vlahos LL, Gouliamos AD, Kailidou ED, Papailiou JG, Angeli SS. MRI features in a malignant glomus jugulare tumour. J Laryngol Otol 1993; 107:1066-9. [PMID: 8288987 DOI: 10.1017/s0022215100125319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Magnetic resonance imaging (MRI) features in a case of malignant glomus jugulare tumour are reported. Chemodectomas are benign in 95 per cent of cases and malignant in five per cent. Only one case report of CT findings in this unusual CP angle tumour with pulmonary metastases has been cited in the literature. It is concluded that MRI can provide useful information about the nature of chemodectomas although it cannot distinguish between benign and malignant tumours, except when regional lymph nodes are involved or when distant metastases exist.
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Abstract
INTRODUCTION Three patients with otologic disorders developed complications related to hypercoagulability. This report was prepared to increase the awareness among otolaryngologists of the diagnosis and management of hypercoagulable states, and to encourage expert consultation when indicated. MATERIALS AND METHODS One patient with dural venous sinus thrombosis complicating an otitis media, one patient with a large glomus jugulare tumor, and one patient with a sudden sensorineural hearing loss were treated by the otolaryngology service. Suspicious thromboembolic events were evaluated by the hematology service, and appropriate anticoagulative therapy was recommended. RESULTS One patient with an inherited hypercoagulopathy and two patients with acquired hypercoagulopathies were treated for otologic problems. Two of the patients were stabilized and discharged on life-long anticoagulation therapy. The third patient, in spite of intensive medical and surgical support, eventually succumbed to complications to which an acquired hypercoagulable state made a significant contribution. Expert consultants made the hematologic diagnoses and treatment recommendations. CONCLUSION Otolaryngologists should be aware that hypercoagulable states may now be more accurately diagnosed and characterized, and that thorough investigation of thromboembolic events may affect treatment decisions.
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Vogl TJ, Mack MG, Juergens M, Bergman C, Grevers G, Jacobsen TF, Lissner J, Felix R. Skull base tumors: gadodiamide injection--enhanced MR imaging--drop-out effect in the early enhancement pattern of paragangliomas versus different tumors. Radiology 1993; 188:339-46. [PMID: 8327675 DOI: 10.1148/radiology.188.2.8327675] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A phase III trial was conducted in 40 patients with known or suspected skull base tumors to evaluate the safety and efficacy of high-dose gadodiamide injection for use as a paramagnetic contrast medium in conventional and dynamic magnetic resonance (MR) imaging. Contrast material enhancement was assessed dynamically with use of a gradient-recalled sequence. The time-intensity curve of selected regions of interest showed a reproducible dropout effect in the form of a dip in the curve during the early enhancement of the sigmoid sinus and jugular bulb; the same phenomenon was observed in all glomus tumors of the skull base, regardless of size or location. In contrast, schwannomas, meningiomas, and a variety of other lesions showed a continuous increase in the time-intensity curve. The drop-out sign, which is probably a result of a paramagnetic phenomenon during the early phase of enhancement, seems to be specific for glomus tumors. High-dose gadodiamide injection may show a specific dynamic pattern for glomus tumors, allowing differentiation from other tumors of the middle and posterior skull base.
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115
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Anand VK, Leonetti JP, al-Mefty O. Neurovascular considerations in surgery of glomus tumors with intracranial extensions. Laryngoscope 1993; 103:722-8. [PMID: 8393507 DOI: 10.1288/00005537-199307000-00003] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Paragangliomas of the skull base, by virtue of their location, locally infiltrative behavior, and vascular nature, are difficult tumors to resect. Surgical removal is especially complicated when intracranial extensions are encountered. Our experience with a one-stage resection of intracranial extensions of glomus tumors in 20 patients is presented. These 20 patients had a total of 29 paragangliomas: 23 glomus jugulare or tympanicum tumors, 5 carotid body tumors, and 1 pterygopalatine lesion. Ten patients had intradural extension; the other 10 had intracranial extradural tumors. The primary complicating treatment factor was the loss of surgical planes in 6 patients with prior surgery and or radiotherapy. The presence of multiple paragangliomas (20%) and catecholamine secretion by the tumors (15%) complicated surgical treatment as well. Surgical morbidity was primarily related to deficits of lower cranial nerves (50%).
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116
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Schnarkowski P, Stoeter P, Wallner B, Goldmann A. [MR tomography and MR angiography of an extensive glomus jugulare tumor]. AKTUELLE RADIOLOGIE 1993; 3:270-2. [PMID: 8364057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The diagnosis of a glomus jugulare tumour was established by MR tomography and MR angiography. MR tomography demarcated the tumour from the surrounding tissue and MR angiography showed the vascularity of the glomus tumour.
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Tali ET, Yuh WT, Mayr NA, Nguyen H, Gao F, Dolan KD. Magnetic resonance imaging of bilateral familial paragangliomas. Ann Otol Rhinol Laryngol 1993; 102:473-7. [PMID: 8512276 DOI: 10.1177/000348949310200612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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118
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Kasemsuwan L, Jenjitranant J, Clongsusuek P. Cholesterol granuloma coincidence with a large and high jugular bulb: report of a case. JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND = CHOTMAIHET THANGPHAET 1993; 76:296-302. [PMID: 8006563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We present a case of right middle ear mass who had an abnormal large jugular foramen, high jugular bulb and large jugular vein on the same side. CT scan could not exclude a glomus tumor. Theoretically, retrograde jugular venography and carotid angiography will give the most useful information. However, in this case we tried to use the MRI scan instead. It showed high signal in T1W, T2W, GRT2W which correlated with blood pigments of methemoglobin in middle ear and mastoid. The low signal in MRI scan T1W, T2W clearly showed enlarged jugular vein, high jugular bulb with diverticulum which helped to excluding a glomus tumor. This finally turned out to be a cholesterol granuloma coincidence with abnormal enlarged jugular foramen and jugular vein. We suggest the MRI scan is very helpful and much safer for patients compared to angiography.
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119
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Wanik M, Majchrzak H, Bierzyńska-Macyszyn G, Maliszewski M, Ladziński P. [A case of lumbar glomeruloma]. Neurol Neurochir Pol 1993; 27:127-9. [PMID: 8502353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A case of the patient with atypical localization of glomus tumor in lumbar region is reported. Trigger pain of unusual intensity resistant to pharmacological treatment ceased immediately after the operation.
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Nägele T, Petersen D, Klose U, Grodd W, Opitz H, Gut E, Martos J, Voigt K. Dynamic contrast enhancement of intracranial tumors with snapshot-FLASH MR imaging. AJNR Am J Neuroradiol 1993; 14:89-98. [PMID: 8427115 PMCID: PMC8334446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE To investigate whether exact evaluation of the dynamic contrast enhancement pattern within intracranial tumors can help to classify tumor histology and vascularity. METHOD Forty-nine patients suffering from different intra- and extraaxial intracranial tumors underwent MR-examination in a 1.5-T superconductive whole body system. After rapid injection of Gd-DTPA, 48 images were acquired during the first 1.5 to 2 minutes of contrast enhancement within the tumors. A fast snapshot-FLASH imaging technique allowed measurement times of 1 second per image. Appearance of Gd-DTPA in a venous sinus served as a temporal reference point. Transformation of 48 discrete measurement points (mean signal values of the enhancing tumor region) into a continuous curve, using a cubic spline approximation, allowed calculation of the time of maximum signal increase (Tm1) and the following time of half maximum increase (Tm2). These time parameters were compared to histopathologic findings, especially the degree of tumor vascularization. RESULTS Significantly different dynamic patterns of the early enhancement period were found for the different tumors. All eight neurinomas, typically less vascularized than most meningiomas, showed a characteristically prolonged contrast enhancement with a long Tm2. Histopathologic findings concerning the degree of vascularization showed two subtypes in meningiomas (n = 17) as well as in pituitary macroadenomas (n = 7). This was confirmed by dynamic evaluation in all cases, in the sense that short Tm1 and Tm2 were found in cases with higher degrees of vascularization. Negatives values of Tm1 were measured in two glomus jugulare tumors, reflecting the arterialization of these vascular tumors. In neuroepithelial tumors (n = 15), the glioblastomas (n = 7) showed very short Tm1 compared to the lower grade gliomas (n = 8). This is explained by histologic findings of pathologic vessels with arteriovenous shunts. CONCLUSION The evaluated dynamic time parameters can be used to narrow differential diagnostic possibilities and to infer the degree of vascularization of intracranial tumors.
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121
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Lloyd GA, Barker PG, Phelps PD. Subtraction gadolinium enhanced magnetic resonance for head and neck imaging. Br J Radiol 1993; 66:12-6. [PMID: 8381324 DOI: 10.1259/0007-1285-66-781-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The subtraction method of Des Plantes has been applied to gadolinium enhanced magnetic resonance imaging (GdMR). Using short acquisition times, T1 weighted spin echo pulse sequences are made immediately before and after the intravenous administration of gadolinium DTPA. To avoid moving the patient from the scanning tunnel the venipuncture is made into the dorsum of the foot. The needle is placed in the vein prior to putting the patient into the scanner and is irrigated with saline while the control series is obtained. 42 patients with naso-sinus or skull base tumours have been successfully investigated by this technique and satisfactory subtraction studies are now obtained on all patients other than the claustrophobic. Subtraction GdMR provides the best demonstration of the effects of gadolinium DTPA on the magnetic resonance signal for both normal and abnormal tissues. The signal recorded on the subtraction image is dependent on tissue blood supply and provides a more accurate record of tumour extent than that shown by unsubtracted GdMR scans.
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van der Mey AG, Frijns JH, Cornelisse CJ, Brons EN, van Dulken H, Terpstra HL, Schmidt PH. Does intervention improve the natural course of glomus tumors? A series of 108 patients seen in a 32-year period. Ann Otol Rhinol Laryngol 1992; 101:635-42. [PMID: 1497267 DOI: 10.1177/000348949210100802] [Citation(s) in RCA: 106] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To acquire more insight into the results of treatment versus the "natural" course of glomus tumors, we studied the clinical data of 108 patients, in 58 of whom the disease was hereditary. During a period of 32 years (1956 to 1988), 175 tumors were diagnosed: 52 glomus jugulotympanic tumors, 32 vagal body tumors, and 91 carotid body tumors. The results of radical surgical treatment were disappointing for tumors located at the skull base, ie, nonradical in 59% (n = 23) of the cases, but very good for the carotid body tumors, for which 96% (n = 68) radical excision was achieved. Moreover, surgery at the level of the skull base dramatically increased morbidity, since it frequently induced cranial nerve palsy. During the follow-up period (maximal observation time 32 years, mean 13.5 years) none of the patients died of residual or recurrent tumor or developed distant metastases, irrespective of the mode and outcome of treatment. When these results are combined with the results of pedigree analysis, a realistic approximation of the "natural" course of the disease for both hereditary and nonfamilial tumors can be made. The results raise the question of whether this natural behavior is really improved by intervention. We conclude that removal of carotid body tumors and solitary vagal body tumors should be considered in order to prevent future morbidity. However, for skull base and bilateral glomus tumors a more conservative monitored "wait and see" policy can be sensible and should be considered in any proposal for treatment of head and neck paragangliomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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Abstract
A survey is given of the clinical picture, diagnosis and management of foramen jugulare paragangliomas (JFP), based on reports of 175 cases from the literature and personal experience of 26 cases. Special emphasis is given to the operative techniques. Improvements of diagnostic possibilities as well as operative techniques, including the pre-operative occlusion of tumour-feeding arteries by endovascular methods have markedly reduced the operative mortality to a rate between 0 and 5 percent. The rate of incomplete removal of C and D tumours dropped to about 15%. But very large and extensive tumours remain a real challenge. Teamwork between neuroradiologists, ENT-surgeons and neurosurgeons is mandatory.
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124
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Thedinger BA, Glasscock ME, Cueva RA, Jackson CG. Postoperative radiographic evaluation after acoustic neuroma and glomus jugulare tumor removal. Laryngoscope 1992; 102:261-6. [PMID: 1545653 DOI: 10.1288/00005537-199203000-00006] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The role of postoperative radiographic follow-up of patients after acoustic neuroma or glomus jugulare tumor removal is unclear and not standardized. The incidence of both lesions is rare and recurrence thought to be unusual. However, a patient with an acoustic neuroma arising in the same ear afflicted with a glomus jugulare tumor removed 5 years earlier prompted a retrospective review of 999 acoustic neuroma and 98 glomus jugulare tumor patients. This review helps to determine the role and frequency of postoperative follow-up, not only to assess recurrence of these lesions but to monitor for the possible development of potential clinically silent new lesions.
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125
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DeAndrea RA, Josephson JS. Pathologic quiz case 4. Glomus jugulare tumor. ARCHIVES OF OTOLARYNGOLOGY--HEAD & NECK SURGERY 1992; 118:216-7, 219. [PMID: 1540359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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