Lower Cranial Nerves Compromise in Glomus Jugulare Tumors

Abstract

Objective: Describe lower cranial nerve compromise (IX to XII) in preoperative and postoperative time of patients with glomus jugulare tumors trying to correlate the relationship with functional outcome with epidemiological variables (age, sex) or variables related to the tumor (extent, location, and relationship to the facial nerve and internal carotid artery).

Method: Retrospective chart review of 53 patients with glomus jugulare submitted to surgical treatment. We searched for lower cranial nerve compromise (LCNC) in preoperative time and at initial PO (until 7 days), PO of 6 months and 1 year. Results of LCNF were compared with tumor aspects and epidemiological features.

Results: The LCNC in preoperative time observed was IX (7/13, 21%), X (11/30, 19%), XI (7/13, 21%), and XII (11/20, 75%). All showed decreased function postoperatively as expected but also recovery with 1 year of PO. Vagus nerve (X) was the most affected at 12 months, showing some degree of symptoms in 23 patients (43.39%). There was no epidemiological evidence of relationship of age and gender with the prevalence of cranial nerve compromise. Patients classified as Fisch-Matto C3/C4 had a higher prevalence of CN involvement preoperatively compared to patients C1/C2 (P < .05). There was statistical significance between the presences of deficits in lower cranial nerves with the degree of tumor extension in the internal carotid artery.

Conclusion: Functional impairment of the lower cranial nerves was observed in the pre- and the postoperative time of patients undergoing surgery for resection of the glomus jugulare tumors and that its frequency was directly proportional to the extent of the tumor and its relationship with internal carotid artery.