12/21/2023 0 Comments Postview skull scructure, 226 patients with glomus jugulare tumors demonstrated a surgical control rate of 93.3 %.ĭespite the relatively high success rate, postoperative complications, such as cranial nerve deficits, are significant causes of morbidity in patients with glomus jugulare tumors that are treated with microsurgery. In a more recent literature review by Suarez et al. of 34 patients who underwent microsurgery for glomus jugulare tumors, GTR was achieved in 91 % with a surgical control rate of 94.2 %. showed that GTR was achieved in 351 (81 %) of 433 patients during the initial surgery for glomus jugulare tumors with an 86 % surgical control rate. A systematic review of seven microsurgery case series with a total of 374 patients showed 88.2 % GTR of tumors during the initial surgery and a surgical control rate of 92.1 %. Recently, many studies have been published that have corroborated this evidence. Surgical control rate (also referred to as tumor control rate) is defined as complete tumor elimination with no evidence of residual or recurrent disease throughout the follow-up period, including patients who have multiple surgeries. Recent studies have repeatedly shown excellent rates of GTR of these lesions and surgical control rates have consistently remained high in numerous studies. The primary goal of the microsurgical management of glomus jugulare tumors is curative GTR. These approaches include mastoid-neck, mastoid-neck with limited facial nerve mobilization, infratemporal fossa type A and B, posterior fossa, subtemporal-infratemporal, retrosigmoid, extreme lateral transcondylar, posterolateral, transmastoid-transcervical, combined infratentorial and posterior fossa, petro-occipital trans-sigmoid, combined transmastoid retro- and infralabyrinthine transjugular transcondylar transtubercular high cervical, infralabyrinthine retrofacial, and various combined approaches. As a result, over time, several approaches for microsurgical resection of glomus jugulare tumors have been described, either as single or staged operations. Early attempts at surgical resection of these tumors were fraught with poor tumor control, high rates of recurrence, and significant morbidity and mortality. i.e.Microsurgical resection remains the treatment of choice for glomus jugulare tumors.there should be equal distance between the mandibular rami and the lateral cranial cortex.if demonstrated posterior to the ethmoid sinuses, further extend the neck or angle more cephalic.if too far anterior to the ethmoid sinuses, depress the patient's chin or angle more caudal.the mandibular mentum should be demonstrated just slightly anterior to the ethmoid sinuses. 4 cm inferior to the mandibular mental point (see Figure 2).ensure the midsagittal plane (MSP) is perpendicular to the receptor.the skull vertex is in contact with the centre of the receptor.the infraorbitomeatal line (IOML) is parallel with the receptor.supine: elevate the shoulders using a firm pillow, allowing the head to tilt backwards.erect: patient leans back on a chair with back support, facing away from the upright bucky.It is imperative that any cervical spine subluxations or fractures on acute trauma patients is excluded before proceeding with this view. This view is useful in assessing potential pathology from trauma or disease progression to the basal skull structures 1-4, including the foramen ovale, foramen spinosum and sphenoid sinuses.
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