Treatment Outcomes for Single Modality Management of Glomus Jugulare Tumors With Stereotactic Radiosurgery

Abstract

Objectives The objectives were to evaluate the audiological outcomes, response of symptoms, and response of tumor volume in patients with glomus jugulare tumors treated solely with single fraction gamma knife radiosurgery. Study Design Single institution retrospective review. Setting Academic, tertiary referral center. Patients The diagnosis code for glomus jugulare was used to identify patients. Only those who underwent gamma knife radiosurgery were included. Those previously treated with any modality were excluded. A total of 12 patients were included for the tumor response and symptom response data and 7 of those were included in the audiometric analysis. Main Outcomes Measures Audiometric data at most recent follow up compared to presentation, subjective improvement in pulsatile tinnitus, and change in tumor volume at most recent follow up compared to pretreatment. Results The average time to most recent follow up was 27.6 months. There was no significant change in pure tone average or word recognition. Pulsatile tinnitus completely resolved or improved in 80% of patients. Cranial neuropathies were stable or improved. A single patient experienced facial nerve paresis 2 years after treatment, which resolved with steroid treatment. Tumor control was 100% and the average change in tumor volume was a decrease of 37%. Conclusion Single modality Gamma Knife radiosurgery treatment of glomus jugulare tumors appears to be safe. Treatment results in decreased tumor volume and improved pulsatile tinnitus in most patients. There was no significant progression of hearing loss after treatment. Lower cranial nerve function remains stable in all patients.

Image‐guided robotic radiosurgery for glomus jugulare tumors—Multicenter experience and review of the literature

“…A total of 29 studies have been identified 9‐37 . One study was a multicenter trial with 132 patients and was counted as a separate publication even though parts of the data had already been reported elsewhere.…”

Radiosurgery of Glomus Tumors of Temporal Bone: a Meta-analysis

“…Fifteen studies met the inclusion/exclusion criteria (Table 1) and were analyzed (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). These studies contained 511 patients studied during 1988 to 2015.…”

Clinical and histopathological principles for the diagnosis of a recurrent paraganglioma of the jugular foramen initially diagnosed as a middle ear adenoma: illustrative case

“…Radiosurgery primarily controls growth of the tumor and may reduce symptoms as a primary or secondary modality. 9 , 10 Resection is another treatment option, particularly if there is existing CN compression with associated neurological deficit. Embolization has been used preoperatively since the 1980s to reduce intraoperative blood loss, 11 although it is not curative by itself 12 and may be associated with higher risk of postoperative CN deficits.…”