Extended Anterolateral Infralabyrinthine Transjugular Approach for Microsurgical Resection of Giant Glomus Vagale Tumor: Operative Video and Technical Nuances

James K. Liu; Kevin Zhao; Soly Baredes; Robert W. Jyung

doi:10.1055/s-0040-1716532

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2021; 82(S 01): S59-S60
DOI: 10.1055/s-0040-1716532

Skull Base: Operative Videos

Extended Anterolateral Infralabyrinthine Transjugular Approach for Microsurgical Resection of Giant Glomus Vagale Tumor: Operative Video and Technical Nuances

James K. Liu

¹Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston and Newark, New Jersey, United States

²Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Livington and Newark, New Jersey, United States

,

Kevin Zhao

¹Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston and Newark, New Jersey, United States

,

Soly Baredes

²Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Livington and Newark, New Jersey, United States

,

Robert W. Jyung

²Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States

³Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Livington and Newark, New Jersey, United States

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Keywords

glomus vagale - paraganglioma - extended anterolateral approach - infralabyrinthine transjugular - skull base surgery - glomus tumor

Fig. 1 Preoperative imaging. (A) Sagittal CT angiogram, (B) axial CT angiogram, and (C) coronal postgadolinium T1-weighted MRI show a large enhancing glomus vagale tumor in the parapharyngeal space extending from C3 to the jugular foramen. The internal and external carotid arteries are displaced anteriorly and the trachea is deviated medially. The tumor was resected using an extended anterolateral infralabyrinthine transjugular approach and a near-total resection was achieved. Postoperative imaging. (D) Sagittal CT angiogram, (E) axial postgadolinium T1-weighted MRI, (F) coronal postgadolinium T1-weighted MRI shows near total resection of the tumor with a small enhancing residual at the pars nervosa (circle in E). CT, computed tomography; MRI, magnetic resonance imaging.

Fig. 2 Intraoperative photograph of a large glomus vagale tumor in the parapharyngeal space. X, vagus nerve; IJV, internal jugular vein.

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Fig. 1 Preoperative imaging. (A) Sagittal CT angiogram, (B) axial CT angiogram, and (C) coronal postgadolinium T1-weighted MRI show a large enhancing glomus vagale tumor in the parapharyngeal space extending from C3 to the jugular foramen. The internal and external carotid arteries are displaced anteriorly and the trachea is deviated medially. The tumor was resected using an extended anterolateral infralabyrinthine transjugular approach and a near-total resection was achieved. Postoperative imaging. (D) Sagittal CT angiogram, (E) axial postgadolinium T1-weighted MRI, (F) coronal postgadolinium T1-weighted MRI shows near total resection of the tumor with a small enhancing residual at the pars nervosa (circle in E). CT, computed tomography; MRI, magnetic resonance imaging.

Fig. 2 Intraoperative photograph of a large glomus vagale tumor in the parapharyngeal space. X, vagus nerve; IJV, internal jugular vein.