颈静脉球体瘤的诊治

目的：探讨颈静脉球体瘤手术进路及临床治疗方法。方法：18例患者术前均行神经耳科、影像学检查，根据肿瘤的大小及肿瘤的部位、扩展方向选择不同的手术入路，即耳内入路6例；耳后入路4例；侧颅底入路、颞下窝入路5例；经颞枕颈联合入路3例。肿瘤全切除14例，次全切除或大部分切除4例。结果：18例中，14例肿瘤全切除均满意，其中2例术后3年复发；4例部分切除术后残留瘤体放疗后1年复查无变化。随访2～6年，复查纯音测听：6例听力恢复平均24dB，12例听力与术前检查结果无明显差异。CT、MRI复查结果：12例患者的术腔为软组织填塞，未见肿瘤复发；2例术后3年出现患耳耳鸣，经CT和MRI检查见乳突腔有瘤组织复发，再次手术治疗后2年随访未见复发；4例次全切除和部分切除的患者，经术后放疗后2年复查CT、MRI，结果与放疗前瘤体的大小无明显差异。结论：手术治疗是颈静脉球体治疗的有效手段，根据肿瘤大小选择手术入路可以确保肿瘤的完整切除，术前肿瘤局部选择性血管栓塞可有效地减少术中出血和手术时间，对于残留组织可用放疗控制其发展。

The diagnosis and treatment of glomus jugulare tumors

Objective:To discuss the diagnosis and management of glomus jugulare tumors.Method:Eighteen cases of jugulare tumors were reviewed.Eighteen different kinds of surgical approaches were selected and used in the eighteen cases,eight cases adjuvant therapies were investigated.Result:After the operation,complete resection was achieved in of the fourteen cases;two had a recurrence after three years ;four patients with residual tumor had nochanges after taking radiotherapy for three years.Conclusion:Surgical approaches allow complete resection of the tumor. And preoperative embolization is able to reduce the operation time and blood loss. Radiotherapy is able to control the residual tumor.