Glomus Tümörlerinde Cerrahi Yaklaşımlarımız
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Dosyalar
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Glomus tümörlerine cerrahi yaklaşımlarımızı sunmak ve sonuçlarımızı değerlendirmek. Hastalar ve Yöntemler: Glomus tümörü tanısı alan 12 olgu dosyaları retrospektif olarak incelenerek bu çalışma kapsamına alındı. Olgular preoperatif dönemde odiyolojik testler (pür tone odiogram, kulak zarının sağlam olduğu olgularda, akustik empedans), anjiografi, bilgisayarlı tomografi ve/veya magnetik rezonans görüntüleme ile değerlendirildiler. Ayrıca idrarda vanil mandelik asit düzeyleri araştırıldı. Glomus jugulare tümörlerinde, infratemporal fossa tip A yaklaşımı, glomus timpanikum tümörlerinde ise transmastoid yaklaşım uygulandı. Subtotal rezeksiyon uygulanan bir olguda kalan tümör dokusuna yönelik olarak radyoterapi uygulandı. Bulgular: Olguların 8’i kadın, 4’ü erkek ve ortalama yaş 54.3 idi. Tanı 8 olguda glomus jugulare ve 4 olguda glomus timpanikum idi. Pulsatil tinnitus, iletim tipi işitme kaybı ve kulakta dolgunluk hissi en sık tesbit edilen semptomlardı. Preoperatif dönemde, glomus jugulare olgularında en az 3 kraniyal sinir paralizisi mevcuttu. Tüm olgularda idrar vanil mandelik asit düzeyleri normaldi. Glomus timpanikum tümörleri total olarak rezeke edildi. Glomus jugulare tümörlerinde ise total rezeksiyon oranı % 87.5 idi. İntrakraniyal uzanım ve internal karotis arter invazyonu gösteren, bir olguda subtotal rezeksiyon ve postoperatif radyoterapi uygulandı. İnfratemporal fossa A yaklaşımı ile opere edilen tüm olgularda geçici fasiyal paralizi ortaya çıktı. Preoperatif olarak etkilenmiş olan diğer kraniyal sinir fonksiyonlarında postoperatif dönemde herhangi bir değişiklik olmadı. Komplikasyon olarak bir olguda beyin omurilik sıvısı fistülü gelişti. 54 ay (11ay-116 ay) olan ortalama takip süreside rezeksiyonun tam olduğu olgularda nüks izlenmedi. Per/postoperatif ölüm izlenmedi. Sonuç: Çalışmamızdan elde edilen sonuçlar glomus timpanikum tümörlerinin transmastoid yaklaşım ve glomus jugulare tümörlerinin infratemporal fossa tip A yaklaşımı ile düşük mortalite ve morbidite oranları ile rezeke edilebildiğini göstermektedir.
Objectives: To present our results in glomus tumor surgery and evaluate the results. Patients and Methods: Twelve cases with glomus tumor were in this study. Preoperatively, all cases were evaluated with audiometric tests (pure-tone audiogram, acoustic impedance), MRI and/or CT, and angiography. Whereas infratemporal fossa type A approach was used for glomus jugulare tumors, transmastoid approach was performed in glomus tympanicum tumors. One case, in which a subtotal resection could be performed, received postoperative radiotherapy in an effort to treat the residual mass. Results: Eight of the cases were female and four of them were male. The avarege age was 54.3. The diagnosis was glomus jugulare in eight cases and glomus tympanicum in four cases. Pulsatile tinnitus, conductive hearing loss and aural fullness were the most common presenting symptoms. In the preoperative period, there were at least three cranial nerve paralyses in each patient. Urine vanyl mandaleic acide levels were in normal limits in all cases. Whereas all glomus tympanicum tumors were resected completely, this rate was 87.5 % for glomus jugulare tumors. In one case with intracranial extension and internal carotid artery invasion, subtotal resection could be performed; for that reason postoperative radiotherapy was used in order to treat the residual mass. Postroperatively, temporary facial nerve paralysis occured in all glomus jugulare cases in which the tumors were resected via infratemporal fossa type A approach. There were no changes for the other cranial nerve paralysis postoperatively. As a further complication, there was one case of a cerebro spinal fluid fistula. There were no recurrences in the totally resected cases during the follow up period which was 54 months (11-116 months) in average. There were no peri or postoperative deaths. Conclusion: The results of our study indicated that glomus tympanicum and glomus jugulare tumors can be resected via the transmastoid and infratemporal fossa type A approaches with minimal morbidity and mortality rates.
Objectives: To present our results in glomus tumor surgery and evaluate the results. Patients and Methods: Twelve cases with glomus tumor were in this study. Preoperatively, all cases were evaluated with audiometric tests (pure-tone audiogram, acoustic impedance), MRI and/or CT, and angiography. Whereas infratemporal fossa type A approach was used for glomus jugulare tumors, transmastoid approach was performed in glomus tympanicum tumors. One case, in which a subtotal resection could be performed, received postoperative radiotherapy in an effort to treat the residual mass. Results: Eight of the cases were female and four of them were male. The avarege age was 54.3. The diagnosis was glomus jugulare in eight cases and glomus tympanicum in four cases. Pulsatile tinnitus, conductive hearing loss and aural fullness were the most common presenting symptoms. In the preoperative period, there were at least three cranial nerve paralyses in each patient. Urine vanyl mandaleic acide levels were in normal limits in all cases. Whereas all glomus tympanicum tumors were resected completely, this rate was 87.5 % for glomus jugulare tumors. In one case with intracranial extension and internal carotid artery invasion, subtotal resection could be performed; for that reason postoperative radiotherapy was used in order to treat the residual mass. Postroperatively, temporary facial nerve paralysis occured in all glomus jugulare cases in which the tumors were resected via infratemporal fossa type A approach. There were no changes for the other cranial nerve paralysis postoperatively. As a further complication, there was one case of a cerebro spinal fluid fistula. There were no recurrences in the totally resected cases during the follow up period which was 54 months (11-116 months) in average. There were no peri or postoperative deaths. Conclusion: The results of our study indicated that glomus tympanicum and glomus jugulare tumors can be resected via the transmastoid and infratemporal fossa type A approaches with minimal morbidity and mortality rates.
Açıklama
Anahtar Kelimeler
Kulak, Burun, Boğaz, Glomus jugulare, Glomus timpanikum, Cerrahi, glomus tympanicum, surgery
Kaynak
KBB-Forum
WoS Q Değeri
Scopus Q Değeri
Cilt
2
Sayı
1
Künye
Ülkü, Ç. H., Uyar, Y., Özkal, E., Öztürk, K., Arbağ, H., (2003). Glomus Tümörlerinde Cerrahi Yaklaşımlarımız. KBB-Forum, 2(1), 6-10.
