Surgical therapy of glomus tympanicum and jugular tumors (GT) with the flexible CO2 laser

Surgery is the gold standard therapy of GT. Via complex approaches, complete resection is possible in most of the cases. Maintaining life quality requires functional preservation during the surgery. The flexible CO2 laser allows a contact-free removal of the tumor. This retrospective study compares postoperative functional outcome of GT surgery with and without the flexible CO2 laser.

Between 2005 and 2017, 58 patients with GT were operated by 2 of the authors. Until 2010, 24 patients received conventional surgery (group (Gr.) A). After that, the flexible laser was used in 34 patients (Gr. B). Tumor extend, pre- and postoperative cranial nerve function, duration of the procedure and complications were compared between the groups. Main symptom was the pulsating tinnitus in both groups. In Gr.A, 14/24 cases were type A tumors, compared to 16/34 in Gr. B. Type A tumors were removed without prior embolisation, hearing preservation was possible in over 90 %. Blood transfusions were necessary in 3 cases in each group, respectively. Regarding the 1-year-follow-up, 3 vagal nerve and 5 facial nerve (partial) palsies were seen in Gr. A compared to 5 and 3 in Gr. B. The mean duration of the surgery was 184 min. in Gr. A and 228 min in Gr. B. No recurrency was observed in Gr. A, whereas 3 were seen in Gr. B. One of these cases required revision surgery. No patient needed a gastric feeding tube.

The cohort of GT which were surgically treated by ENT specialists is one of the largest ever published. There was no statistically significant advantage of the CO2 laser compared to conventional surgery. However, we could demonstrate that the flexible laser is a safe and effective alternative which is appreciated by our team for these highly vascularized tumors.

Poster-PDF A-1970.PDF

Publication History

Article published online:
10 June 2020