Skull Base 2011; 21(5): 309-312
DOI: 10.1055/s-0031-1284212
ORIGINAL ARTICLE

© Thieme Medical Publishers

Fibrin Sealant Injection: An Aid to Reduce Venous Bleeding during Jugular Bulb and Sigmoid Sinus Dissection in Glomus Jugulare (Jugulotympanic Paraganglioma) Surgery

Richard James List1 , Sebastien Philippe Henry Thomas1 , Emad Shenouda2 , Dorothy Lang2 , Anne Davis3 , Nijaguna Mathad2
  • 1Department of ENT, Southampton University Teaching Hospitals NHS Trust, Southampton, Hampshire
  • 2Department of Neurosurgery, Southampton University Teaching Hospitals NHS Trust, Southampton, Hampshire
  • 3Department of ENT, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
Further Information

Publication History

Publication Date:
21 July 2011 (online)

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ABSTRACT

Glomus jugulare (jugulotympanic paraganglioma) surgery requires tumor dissection in the region of the jugular bulb, upper internal jugular vein, and sigmoid sinus. Despite ligation or external compression of the sigmoid sinus proximally and ligation of the internal jugular vein distally, troublesome venous bleeding can arise from the inferior petrosal sinus or condylar veins at the medial wall of the jugular bulb. Excessive packing in this area can place the integrity of the lower cranial nerves at risk. We report a technique in which Tisseel® fibrin sealant is injected into the ligated sigmoid sinus and internal jugular vein. This forms an internal cast around the tumor in the sigmoid-jugular complex and helps seal the inferior petrosal sinus and condylar veins. This allows for safer dissection with reduced venous bleeding. Our experience in five cases has shown this technique to be effective.

REFERENCES

Richard James ListB.Med.Sci. B.M.B.S. M.R.C.S. D.O.H.N.S. 

ENT Department, Southampton University Hospitals NHS Trust

Tremona Road, Southampton, Hampshire SO16 6YD

Email: richlist@gmail.com