CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2021; 82(S 01): S59-S60
DOI: 10.1055/s-0040-1716532
Skull Base: Operative Videos

Extended Anterolateral Infralabyrinthine Transjugular Approach for Microsurgical Resection of Giant Glomus Vagale Tumor: Operative Video and Technical Nuances

James K. Liu
1   Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston and Newark, New Jersey, United States
2   Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States
3   Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Livington and Newark, New Jersey, United States
,
Kevin Zhao
1   Department of Neurological Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston and Newark, New Jersey, United States
,
Soly Baredes
2   Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States
3   Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Livington and Newark, New Jersey, United States
,
Robert W. Jyung
2   Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Newark, New Jersey, United States
3   Center for Skull Base and Pituitary Surgery, Rutgers New Jersey Medical School, Neurological Institute of New Jersey, Saint Barnabas Medical Center, RWJ Barnabas Health, Livington and Newark, New Jersey, United States
› Author Affiliations

Abstract

Glomus vagale tumor is a paraganglioma of the vagus nerve. It is a rare type of benign tumor that occupies the head and neck and skull base regions. Patients often present with lower cranial nerve dysfunctions such as difficulty swallowing, tongue weakness, and hoarseness. Surgical treatment can be complex and difficult due to its high vascularity, frequent involvement of lower cranial nerves, and surrounding critical vascular structures. In this operative video, we demonstrate an extended anterolateral infralabyrinthine transjugular approach for microsurgical resection of a giant glomus vagale tumor in a 53-year-old male who presented with an enlarging neck mass, difficulty swallowing, right tongue weakness, and hoarseness. Imaging revealed a giant glomus vagale tumor in the right parapharyngeal space extending into the jugular foramen with occlusion of the internal jugular vein. After preoperative embolization, the patient underwent a near-total resection of the tumor with a small microscopic residual at the pars nervosa. In summary, the extended anterolateral infralabyrinthine transjugular approach is a useful strategy for removal of giant glomus vagale tumors extending into the skull base. The surgical technique and nuances are described in a step-by-step fashion in this illustrative operative video.

The link to the video can be found at: https://youtu.be/L0EosQK95LE.



Publication History

Received: 25 June 2020

Accepted: 25 June 2020

Article published online:
26 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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