[Diagnosis and treatment of glomus jugulare tumor]

Abstract

Objective: To investigate the clinical features, diagnosis, and treatment of glomus jugulare tumor.

Methods: The data of 37 patients of glomus jugulare tumor diagnosed by digital subtraction angiography (DSA) and/or operation and pathology, 14 males (37.8%) and 23 females (62.2%), with an average age of 37.2 (3.5 approximately 66 years) and an average course of 4.3 years (1 month - 19 years), were analyzed.

Results: The tumor was located in the left ear in 19 cases, in the right ear in 17 cases, and in both ears in 1 case, totally 38 ears. The tumor was chromaffin in one case with hypertension. One case was complicated by ipsilateral carotid body tumor, and 2 cases were complicated by ipsilateral cholesteatoma. Thirty cases (81.1%) presented pulsatile tinnitus and hearing loss as the main symptoms. Thirteen cases (35.1%) were diagnosed as glomus jugulare tumor at the first visit, and 24 cases (64.9%) were diagnosed as other diseases with an average misdiagnosis period of 4.4 years. Eighteen tumors originated from typanum and 28 tumors from glomus jugulare. According the Fisch classification 1981, the tumors in 11 ears were type A, in 7 ears were type B, in 7 ears type C, in 5 ears type D1, and in 8 ears type D2. All cases, except the one with bilateral lesions, underwent operation. The tumor was completely resected in 30 cases. Postoperatively, facial paralysis was seen in 6 cases, dizziness, hoarseness, and subauricular necrosis was seen in one case respectively. Of the 25 patients followed up with a mean follow-up time of 5.2 years (1.1 - 16.1 years), 3 died of lung cancer, neuroblastoma, or extensive involvement of glomus jugulare tumor respectively, 19 survived without tumor, and 3 survived with the tumor.

Conclusion: Glomus jugulare tumor is likely to involve surrounding important tissues, and to be misdiagnosed. Early surgical removal of the lesion is important.