SURGICAL THERAPY OF GLOMUS-VAGALE TUMORS

Lying between the carotid bifurcation and the jugular foramen, glomus vagale tumors share characteristics with paragangliomas of those two s tructures, such as invasion of the carotid artery, destruction of the skull base, and cranial neuropathies. This capability for local invasi on provides a therapeutic challenge with regard to the proper assessme nt of tumor extent and the selection of appropriate treatment. In orde r to clarify an approach to the management of glomus vagale tumors, we reviewed a 10-year experience with 15 patients treated for this tumor at the University of Zurich Department of Otolaryngology, using a new system of classification. This system highlights the relative positio n of a vagal paraganglioma to the jugular foramen and is helpful in de signing the proper therapy. Pitfalls in surgical technique, recommende d pre-operative evaluation, and the roles of balloon occlusion and irr adiation in the treatment of these tumors are discussed.