Evaluation of preoperative intra-arterial embolization of glomus jugular tumors

ABSTRACT

Superselective preoperative percutaneous transfemoral catheter embolization by using polyvinyl alcohol particles of feeding vessels in glomus jugulare tumors, followed two-three days by application of standard surgical techniques, presents the treatment of choice, allowing meticulous microsurgery with virtually complete haemostasis. Therefore, the surgeon can operate in a bloodless environment throughout the compressed anatomic field, amidst such important yet vulnerable structures as cranial nerves, inner ear, carotid artery, jugulare bulb, venous sinuses and dura, while reducing surgical error and functional deficit for the patient. The value of this combined approach was analyzed for the management of ten patients suffered from glomus tumors at Assiut University Hospital. The results showed that even extensive tumors of the middle ear, jugulare bulb and mastoid had only minor blood losses and good surgical outcome with this treatment modality. Combined embolization and surgery offer the best approach for the treatment of respectable glomus jugulare tumors