Role of Stereotactic Radiosurgery in Skull Base Paragangliomas - A Narrative Review

Skull base paragangliomas, also known as glomus tumors, are grouped as glomus jugulare or glomus tympanicum. Paragangliomas are rare tumors, with an estimated incidence of 1 case per million persons. They occur more commonly in females and are more common in the fifth or sixth decade of life. Management of these tumors traditionally involved surgical excision. However, surgical excision can result in high complication rates, particularly cranial nerve palsies. Stereotactic radiosurgery has been shown to yield tumor control rates of more than 90%. A recent meta-analysis reported improvement in neurological status in 48.7% of cases, while it stabilized in 39.3% of patients. Transient deficits such as headache, nausea, vomiting, and hemifacial spasm developed following SRS in 5.8% of patients, while 2.1% of patients developed permanent deficits. There is no difference in the rate of tumor control between different radiosurgery techniques. Dose-fractionated SRS can be used for large tumors to decrease the risk of radiation-induced complications.