Treatment of glomus tympanicum tumors by preoperative embolization and total surgical resection

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• 作者：Lien Devuyst ; MD^a ; ¹ ; ^{lienneil@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Luc Defreyne ; MD ; PhD^b ; ^{Luc.Defreyne@uzgent.be" class="auth_mail" title="E-mail the corresponding author} ; Marleen Praet ; MD ; PhD^c ; ^{Marleen.Praet@ugent.be" class="auth_mail" title="E-mail the corresponding author} ; Sven Geukens ; MD^d ; ^{Sven_geukens@yahoo.co.uk" class="auth_mail" title="E-mail the corresponding author} ; Ingeborg Dhooge ; MD ; PhD^a ; ^{ingeborgh.dhooge@ugent.be" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ABG ; Air Bone gap ; AC ; Air Conduction ; BC ; Bone Conduction ; DSA ; Digital subtraction angiography ; HRCT ; High-resolution CT images ; PTA ; pure tone average ; SRS ; stereotactic radiosurgery
• 刊名：American Journal of Otolaryngology
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：37
• 期：6
• 页码：544-551
• 全文大小：892 K

文摘

The purpose of this study was to evaluate the effectiveness on function preservation and tumor control of the treatment of glomus tympanicum tumors with pre-operative embolization followed by total surgical resection.

Material and methods

We describe a series of 6 patients with a glomus tympanicum tumor who were treated in our hospital using the same technique: the day before surgery selective tumor embolization due to denaturation with 96% ethanol. Following parameters were considered: tumor classification, tumor control, clinical and audiological outcome, effectiveness of embolization, percentage of tumor necrosis and treatment complications.

Results

There were no severe complications due to embolization or surgery. Tumor blush disappeared completely in 5 patients on DSA post embolization and histologic evaluation of the resected tissue showed a median of 69.2% of tumor necrosis. Pulsatile tinnitus disappeared in all patients and 3 patients had no symptoms at all. Hearing ameliorated in 4 patients, 1 patient without hearing loss pre- treatment still had normal hearing after treatment and 1 patient's hearing was worse after treatment. Average follow-up was 21.3 months.

Conclusions

Treatment of glomus tympanicum tumors by pre-operative embolization with ethanol and surgical resection has not been described before. Our results show that it is a safe procedure with a good long term tumor control, good clinical and audiological outcome.