Background: There are various treatments such as surgery, radiotherapy, embolization or combination
therapies for glomus jugular tumors. Selecting an effective treatment for a glomus
jugular tumor has been a challenging controversy for decades. We conducted a retrospective
study to compare treatment success and complications after surgery or radiotherapy
in patients with glomus jugular tumors.
Methods: We retrospectively studied 58 patients who received treatment for Types B, C, and
D (Fisch classification) glomus jugular tumors from 2009 to 2019 at two institutions.
Forty-three patients were treated with type A infratemporal fossa surgical approach.
Of the 15 patients who received radiotherapy, 11 patients underwent 30 sessions of
radiotherapy with a total cumulative dose of 5,520 cGy, one patient underwent 21 sessions
with a total cumulative dose of 3,864, and 3 cases underwent 33 sessions with a total
cumulative dose of 6,600 cGy.
Results: The mean follow-up period of patients in the surgical group was 26.74 ± 18.85 months
and in the radiotherapy group was 26.8 ± 11.24. Postoperative local control rates
for type B, C1, and C2 tumors were 100, 93, and 92%, respectively. Local control after
radiotherapy for these tumors was 100%. The rates of cranial nerve injury in the surgery
group for type B and C1 and C2 tumors were 0, 8, and 0%, respectively. This rate was
25 and 33% in radiotherapy groups for C1 and C2 tumors, respectively. Local control
rates for tumors C3 and C2DeDi after surgery were 50 and 89%, respectively, and after
radiotherapy were 66 and 60%, respectively. Cranial nerve injury was found in 66 and
33% in surgery group for type C3 and C2DeDi tumors. There was no cranial nerve damage
after radiotherapy in these types of tumors. In types B, C1, and C2, the rate of cranial
nerve complications was lower in the surgical group than in the radiotherapy group
(p < 0.001). However, in more advanced types of the Fisch classification (C3 and C2DeDi),
the rate of these complications was higher in the surgery group (p < 0.001). The extent of cranial nerve injury after radiotherapy did not depend on
the classification, but in the surgical group, the more advanced the classification,
the greater the complication rates are.
Conclusion: Surgery seems to be a suitable primary treatment method in the patients with types
B, C1, and C2 glomus tumors, considering the appropriate local control and low cranial
nerve injury rate. However, in type C3 and C2DeDi tumors, due to equal local control
in surgery and radiotherapy and a higher rate of complications in surgery, radiotherapy
can be suggested as the primary method of treatment.