[Surgery of extensive glomus jugulare tumors (author's transl)].

Clinical and neuroradiological aspects of extensive glomus jugulare tumors are presented. Surgery of these tumors is based on their growth along the veins: caudally along the internal jugular vein, cranially along the sigmoid sinus and medially along the transbasilar veins up to the cavernosus sinus. The main problem in total removal of glomus jugulare tumors is the relieving of the internal carotid artery from the tumor, especially in its intrapyramidal part. It is well known that glomus jugulare tumors tend to bleed excessively during surgery. Therefore the branches of the external carotid artery and the transverse sinus are ligated at the beginning of the operation. To avoid infection from the Eustachian tube to the posterior fossa, to close the dural defect over the cerebellar hemisphere and to protect the internal carotid artery a pedicled flap of the sternocleidomastoid muscle, based cranially, is prepared and rotated upwards in the base of the skull. 9 cases of extensive glomus jugulare tumors are presented.