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Volume 12 Issue 6
Nov.  2021
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ZHANG Wenyang, XUE Yubin, YE Ting, QU Xiaopeng, YAN Xukun, WANG Pu, LIU Qiang, XIA Yin. The Clinical Effects of Modified Infratemporal Fossa Approach Type A for Glomus Jugulare Tumors in 39 Patients[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 940-945. DOI: 10.12290/xhyxzz.2021-0564
Citation: ZHANG Wenyang, XUE Yubin, YE Ting, QU Xiaopeng, YAN Xukun, WANG Pu, LIU Qiang, XIA Yin. The Clinical Effects of Modified Infratemporal Fossa Approach Type A for Glomus Jugulare Tumors in 39 Patients[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(6): 940-945. DOI: 10.12290/xhyxzz.2021-0564
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The Clinical Effects of Modified Infratemporal Fossa Approach Type A for Glomus Jugulare Tumors in 39 Patients

  • Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Funds: 

Capital's Funds for Health Improvement and Research 2016-2-2046

More Information
  • Corresponding author:

    XIA Yin  Tel: 86-10-59976698, E-mail: xiayin3@163.com

  • Received Date: July 28, 2021
  • Accepted Date: October 07, 2021
  • Issue Publish Date: November 29, 2021
    Graphical Abstract
    • Abstract
  •   Objective  To analyze the clinical effects of modified infratemporal fossa type A approach for glomus jugulare tumors.
      Methods  The clinical data of patients with glomus jugulare tumors who received modified infratemporal fossa approach type A from May 2014 to December 2019 were retrospectively collected in the Beijing Tiantan Hospital, Capital Medical University. Modified infratemporal fossa approach type A was performed and improved on two aspects: anterior transfer of facial nerve and management of sigmoid sinus. CT was performed 6 hours after surgery to exclude intracranial hemorrhage. MRI was reviewed 2 weeks after surgery to define residual tumor, and every year to determine recurrence. Follow-up was conducted to assess the facial nerve function.
      Results  A total of 39 patients were included in this study. Patients' grades of preoperative facial nerve function according to House-Brackmann (HB) were as following: grade Ⅰ in 12 patients, grade Ⅱ in 6 cases, grade Ⅲ in 8 cases, grade Ⅳ in 9 cases, grade Ⅴ in 3 cases, and grade Ⅵ in 1 case. All 39 patients successfully completed surgery, and there were no deaths and no severe complications such as hemiplegia, or intracranial infections. Cerebrospinal fluid leakage occurred in 1 case and drainage was performed. There was no intracranial hemorrhage in the CT exam 6 hours after surgery. Total resection was performed in 37 cases (94.9%) and nearly total resection in 2 cases (5.1%). The postoperative facial function after 1 year was HB grade Ⅰ in 8 patients, grade Ⅱ in 16 cases, grade Ⅲ in 9 cases, grade Ⅳ in 4 cases, grade Ⅴ in 2 cases. The facial function was improved after the surgery(P < 0.05). One year after surgery, tumor recurrence occurred in 1 patient and radiotherapy was performed. There was no significant tumor enlargement during follow-up.
      Conclusions  The modified infratemporal fossa approach type A keeps the advantage of classical approach. By adjusting the anterior transfer of the facial nerve, the preservation of facial nerve function was improved. By compressing the sigmoid sinus instead of ligation, the occurrence of brain injury and cerebrospinal fluid leakage were reduced.
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    • References (18)
  • [1]
    Heth J. The basic science of glomus jugulare tumors[J]. Neurosurg Focus, 2004, 17: E2. http://www.onacademic.com/detail/journal_1000039216628310_a236.html
    [2]
    Al-Mefty O, Teixeira A. Complex tumors of the glomus jugulare: Criteria, treatment, and outcome[J]. Neurosurg, 2002, 97: 1356-1366. DOI: 10.3171/jns.2002.97.6.1356
    [3]
    Moore MG, Netterville JL, Mendenhall WM, et al. Head and neck paragangliomas: An update on evaluation and management[J]. Otolaryngol Head Neck Surg, 2016, 154: 597-605. DOI: 10.1177/0194599815627667
    [4]
    Carlson ML, Sweeney AD, Wanna GB, et al. Natural history of glomus jugulare: a review of 16 tumors managed with primary observation[J]. Otolaryngol Head Neck Surg, 2015, 152: 98-105. DOI: 10.1177/0194599814555839
    [5]
    Fisch U. Infratemporal fossa approach for glomus tumors of the temporal bone[J]. Ann Otol Rhinol Laryngol, 1982, 91: 474-479. DOI: 10.1177/000348948209100502
    [6]
    Fisch U. The infratemporal fossa approach to tumors of the temporal bone and the base of the skull[J]. J Laryngol Otol, 1978, 92: 949-967. DOI: 10.1017/S0022215100086382
    [7]
    Rickenmann J, Jaquenod C, Cerenko D, et al. Comparative Value of Facial Nerve Grading Systems[J]. Otolaryngol Head Neck Surg, 1997, 117: 322-325. DOI: 10.1016/S0194-5998(97)70120-7
    [8]
    Bikhazi PH, Roeder E, Attaie A, et al. Familial paragangliomas: the emerging impact of molecular genetics on evaluation and management[J]. Am J Otol, 1999, 20: 639-643.
    [9]
    夏寅, 严旭坤. 颈静脉球副神经节瘤治疗策略[J]. 中华耳科学杂志, 2019, 17: 339-342. DOI: 10.3969/j.issn.1672-2922.2019.03.012

    Xia Y, Yan XK. Treatment Strategies for Temporal Bone Paraganglioma[J]. Zhonghua Erkexue Zazhi, 2019, 17: 339-342. DOI: 10.3969/j.issn.1672-2922.2019.03.012
    [10]
    魏兴梅, 高志强, 许志勤, 等. 不同颞下窝进路联合技术切除侧颅底病变[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55: 814-821. DOI: 10.3760/cma.j.cn115330-20191015-00627

    Wei XM, Gao ZQ, Xu ZQ, et al. Surgery technique of combined different infratemporal fossa approaches for lesions in lateral skull base[J]. Zhonghua Er Bi Yanhou Toujing Waike Zazhi, 2020, 55: 814-821. DOI: 10.3760/cma.j.cn115330-20191015-00627
    [11]
    Jackson CG. Glomus tympanicum and glomus jugulare tumors[J]. Otolaryngol Clin North Am, 2001, 34: 941-970. DOI: 10.1016/S0030-6665(05)70356-X
    [12]
    Watkins LD, Mendoza N, Cheesman AD, et al. Glomus jugulare tumors: a review of 61 cases[J]. Acta Neurochir (Wien), 1994, 130: 66-70. DOI: 10.1007/BF01405504
    [13]
    Makiese O, Chibbaro S, Marsella M, et al. Jugular foramen paragangliomas: management, outcome and avoidance of complications in a series of 75 cases[J]. Neurosurg Rev, 2012, 35: 185-194. DOI: 10.1007/s10143-011-0346-1
    [14]
    Jackson CG, Harris PF, Glasscock ME, et al. Diagnosis and management of paragangliomas of the skull base[J]. Am J Surg, 1990, 159: 389-393. DOI: 10.1016/S0002-9610(05)81279-6
    [15]
    Fayad JN, Keles B, Brackmann DE. Jugular Foramen Tumors: Clinical Characteristics and Treatment Outcomes[J]. Otol Neurotol, 2010, 31: 299-305. DOI: 10.1097/MAO.0b013e3181be6495
    [16]
    Leonetti JP, Anderson DE, Marzo SJ, et al. Facial Paralysis Associated With Glomus Jugulare Tumors[J]. Otol Neurotol, 2006, 28: 104-106. http://www.onacademic.com/detail/journal_1000039170410310_cea6.html
    [17]
    Samii M, Alimohamadi M, Gerganov V. Surgical Treatment of Jugular Foramen Schwannoma: Surgical Treatment Based on a New Classification[J]. Neurosurgery, 2015, 77: 425-432. http://europepmc.org/abstract/MED/26075309
    [18]
    Liu JK, Sameshima T, Gottfried ON, et al. The combined transmastoid retro- and infralabyrinthine transjugular trans-condylar transtubercular high cervical approach for resection of glomus jugulare tumors[J]. Neurosurgery, 2006, 59: 115-125. DOI: 10.1227/01.NEU.0000219241.92246.FB
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