Contemporary management of jugular paragangliomas (glomus tumours): microsurgery and radiosurgery

Excerpt

There is a renewed interest in the management of jugular foramen tumours. Although in that locality of the skull base occasionally one does find meningiomas, neurofibromas, metastatic tumours, primitive neuroectodermal tumours, or extrinsic tumours like chordomas, chondrosarcomas and even the occasional misdiagnosis caused by jugular bulb flow variants, the commonest pathologies encountered are paragangliomas. These tumours arise from paraganglia or glomus cells in the adventitia of the jugular bulb. When they develop in the bony wall of the tympanic canal (glomus tympanicum) or in the middle ear, they fall into the exclusive realm of Ear Nose and Throat surgery and neurosurgeons get involved almost exclusively only with these tumours in the jugular foramen. These are commonly described as glomus tumours. An article in this issue of Acta Neurochirurgica describes the radiosurgical experience in their management. …