Clinical and Radiological Response Following Single-Session Gamma Knife Radiosurgery in Glomus Jugulare Tumors

Aprajita Chaturvedi; Nishanth Sadashiva; Arun Thimmarayappa; Divisha Nagpal; Sushrut Baligar; Subhas Konar; Manish Beniwal; Andiperumal R. Prabhuraj; Vikas Vazhayil; Arivazhagan Arimappamagan

doi:10.1055/a-2640-3710

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base
DOI: 10.1055/a-2640-3710

Original Article

Clinical and Radiological Response Following Single-Session Gamma Knife Radiosurgery in Glomus Jugulare Tumors

Aprajita Chaturvedi

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Nishanth Sadashiva

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Arun Thimmarayappa

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Divisha Nagpal

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Sushrut Baligar

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Subhas Konar

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Manish Beniwal

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Andiperumal R. Prabhuraj

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Vikas Vazhayil

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

,

Arivazhagan Arimappamagan

¹Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India

› Author Affiliations

Abstract

Introduction

Glomus tumors are rare, slow-growing, hypervascular skull base tumors and frequently involve critical neurovascular structures. Surgical resection is technically challenging and is associated with high morbidity rates due to lower cranial nerve injury and CSF leak. Gamma knife radiosurgery (GKRS) has revolutionised the management of these lesions with high clinical and tumor control rates and a low side effect profile. In this study, we have attempted to study the tumor and clinical control rate along with the prediction factors.

Methods

This is a retrospective data review of all patients with glomus jugulare tumors from 2010 to 2023 who underwent GKRS in our center. Clinical, neuroimaging, and radiosurgical treatment were re-reviewed, and all patients' prognostic factors for clinical and tumor control were analyzed.

Results

The study included 95 patients. The median age was 45 years, with three-fourths of our patients being female, 69 (72.6%). Hearing loss was the most common symptom. The median marginal dose at the 50% isodose line was 16 Gy. The mean tumor volume was 8.7 cc, and the mean treatment volume was 8.3 cc. The tumor control rate in our study period was 96.9%. Younger age and Glasscock–Jackson type 1 were found to be worse and a good prognostic factor, respectively. The clinical control rate in our study was 93.9%, with no related significant prognostic variable in our study.

Conclusion

Gamma knife is a safe and effective treatment option for these formidable tumors with a very low complication rate.

Keywords

glomus jugulare tumor - radiosurgery - gamma knife radiosurgery - lower cranial nerve

Full Text

References

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