颈静脉鼓室球瘤的治疗

Jugulotympanic glomus tumors:a report of 11 cases

目的 探讨颈静脉鼓室球瘤的手术方法。方法 回顾性分析 1982～ 1998年 11例手术治疗的颈静脉鼓室球瘤 (鼓室球瘤Ⅱ型 1例、Ⅲ型 1例及Ⅳ型 3例 ;颈静脉球瘤Ⅰ型 1例、Ⅲ型 5例 )术式及治疗效果。结果 肿瘤均予以完全切除 ,术后均一期愈合。 1例术后喉返神经麻痹。术后随诊 1～ 8年 ,平均 3年 9个月 ,无复发者。结论 鼓室球瘤宜采用耳后切口入路 ;颈静脉球瘤Ⅰ型采用耳后切口向下延长至颈部 ,III型采用耳后大C形切口行颞骨、颞下窝及颈部肿瘤切除。

Objective To evaluate the surgical technique in removal of jugulotympanic glomus tumor. Methods Retrospective analysis of surgical techniques and effects of the surgical treated 11 cases (1982 1998) of jugulotympanic glomus tumors (tympanic type I、1,II、1,IV、3; jugular type I、1, III、5). Results The tumors of all 11 patients were removed completely and the wounds healed smoothly. Only one case had postoperative laryngeal nerve paralysis. There was no recurrence after 1 8 years follow up. Conclusion Suitable surgical techniques are available for removal of jugulotympanic glomus tumors and are chosen according to the size and location of the tumor. Postauricular incision is suitable for Glomus tympanicum Type II、III、IV. Since postauricular incision with superior and inferior extension provides a good exposure of the neck and temporal bone, it is suitable for surgical removal of Glomus jugulare type I. In case of Glomus jugulare type III, postauricular large “C” incision may be chosen for resection of the mid and infra temporal fosse, neck and skull base tumor.