THE SURGICAL-MANAGEMENT OF PATIENTS WITH GLOMUS TUMORS OF THE SKULL BASE

Total surgical excision is the only treatment modality that offers a c ure for patients with glomus rumours of the skull base. The vascularit y, inaccessibility and frequently extensive local spread, all contribu te to the difficulties encountered in the management of patients with these complex lesions. Owing to the rarity of skull base glomus rumour s, experience in their management can only be attained over long perio ds of time. We describe the surgical management of 20 patients with la rge glomus rumours of the skull base treated by an otoneurosurgical te am over an Ii-year period. Overall, 70% of patients had an excellent o utcome, 10% a good outcome and 20% a poor outcome at a mean follow-up of 3.1 years. Poor outcomes were due to severe facial nerve palsies in two cases, and poorly accommodated palsies of the bulbar cranial nerv es in a further two patients. The management of postoperative neurolog ical deficits is discussed in detail. We conclude that in the majority of patients with skull base glomus rumours, complete surgical excisio n can be safely achieved.