Lateral skull base surgery for glomus tumors: Long-term control

Objective: The age of modern microsurgery has made resection of glomus tumo rs with extensive skull base involvement possible. Resection of extensive l esions is not without risk of major complication or new cranial nerve defic it. Because glomus tumors are rare and slow growing, data reflecting recurr ence risk after resection using modern skull base techniques are lacking. T hese factors complicate the accurate definition of efficacy of surgical res ection and its functional cost. The object of this review is to determine t he current incidence of major complications, the surgical cranial nerve def icit, the long-term control rate, and the recurrence risk in patients under going surgical resection of glomus jugulare tumors. Study Design: Retrospective case review. Setting: Private practice tertiary referral center. Patients and Interventions: One hundred seventy-six patients with glomus tu mors underwent 182 lateral skull base resections between 1972 and 1998. Main Outcome Measures: Major complications, tumor recurrence, postoperative functional capacity, and factors affecting the incidence of each were asse ssed. Results: Complete surgical control was achieved in 85% of cases. There were nine cases of recurrence, fur a recurrent rate of 5.5% (9/164). Cerebrospi nal fluid leakage occurred in 4.5% of cases with intracranial extension. Ne w deficits for cranial nerves IX, X, XI. and XII occurred in 39%, 25%, 26%, and 21% of cases, respectively. Satisfactory functional recovery was achie ved in an overwhelming majority of casts. The mortality rate was 2.7% (5/18 2). Conclusions: Surgical resection of glomus tumors is established as an effec tive technique with good functional outcomes and long-term control.