Functional recovery after surgical approach of jugulotympanic glomus tumors

Abstract

Abstract Paragangliomas are tumors of the neuroendocrine system, which arise from the neural crest and chemoreceptor cells. They can be found in the adrenal gland, in the aortic arch, in the jugular bulb or at the level of the cochlear promoter. Glomus tumors grow slowly, are well vascularized, invasive and locally aggressive. Because of their anatomic relation with the jugular bulb, the internal carotid artery, the facial nerve and the cranial nerves IX, X, XI, XII, the patients may develop important complications. Therapeutic options for head and neck paragangliomas are surgical treatment with endovascular embolization, conventional radiotherapy, stereotactic radiosurgery or a combination of these therapeutic methods. In case of paragangliomas, it is essential to take into consideration the size and localization of the tumor, in order to establish the proper therapeutic approach, either conservative, radiotherapy or surgical, due to the risk of postoperative nerve palsies, details that we try to cover in this review. In order to emphasise the importance of correct diagnosis, proper treatment, postoperative complications and postoperative functional recovery in the case of glomus tumors, we present the case of a 35-year-old female who was diagnosed and surgically treated for a right jugulotympanic paraganglioma. The postoperative cranial nerve injuries involved VII, IX and X nerves and the patient followed multiple protocols of functional recovery for the affected nerves. After specific therapy, the patient partially recovered the function of the right facial nerve; deglutition and voice were significantly improved.