Preservation of hearing in glomus jugulare tumor surgery

Growing experience with adequate surgical exposure of GJT makes sacrifice of the external, and middle ear components not necessary in every case. In a series of 21 patients, microscopically complete resection was achieved by the canal wall up approach with extended facial recess. The decision to leave the middle ear intact depended on the preoperative hearing loss, and most importantly on the tumor size, e.g. extra- or intradural spread, and growth along the internal carotid artery. Hearing remained unchanged after surgery in 62% of patients, and a serviceable hearing was preserved in 28% of patients. In spite of hearing preservation the incidence of residual tumor was 11%. The diagnostic value of MRI contrast-enhanced-intensity-versus-time studies in the differentiation of postoperative recurrence versus granulation or scar formation is discussed.