Long-Term Surgical Results for Glomus Temporale Tumors

Purpose: The purpose of the study is to evaluate a series of patients with glomus temporale tumors and to review survival, complications, cranial nerve function, and functional status. Methods: Retrospective review of 33 patients with glomus temporale tumors. Results: Complete surgical removal was achieved in 96% of patients, and subtotal removal was achieved in 4%. There was no operative mortality. Seventy-five percent of the patients had a grade I or II/ VI on the House-Brackman scale rating facial nerve function 6 months after surgery. After surgery, 36% of patients had hearing that was within normal limits. Another 36% were anacoustic or had no useful hearing. Hoarseness was present in 18% of patients. Seven percent required long-term feeding tubes because of swallowing dysfunction and aspiration. Fourteen percent did not return to work in the same capacity of preoperative employment. Conclusions: Facial nerve function is worse with complete facial nerve transposition, and postoperative nerve function improves with less mobilization of the nerve and the surgical team's experience. Partial facial nerve transposition in properly selected patients can improve postoperative facial nerve outcomes. Hearing improvement and preservation are attainable. The large majority (93%) of patients return to the work force. Aspiration and swallowing abnormalities from lower cranial nerve problems, particularly the vagus nerve, are the most difficult to manage.