title: Preoperative embolization of the inferior petrosal sinus in surgery for glomus jugulare tumors.
abstract: OBJECTIVE
  To compare the outcomes of surgery for glomus tumors involving the jugular foramen with and without preoperative venous embolization of the inferior petrosal sinus (IPS).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Twenty-four patients with paragangliomas involving the jugular foramen treated between 1995 and 2008.
  
  
  METHODS
  All patients underwent surgical resection after receiving preoperative angioembolization with or without venous embolization of the IPS.
  
  
  METHODS
  Total operative duration, estimated blood loss, intensive care unit and total hospital days, and novel postoperative lower cranial nerve deficits were recorded, and appropriate statistical analysis was conducted.
  
  
  RESULTS
  Twenty-four patients met inclusion criteria. Fourteen of these patients underwent preoperative embolization of the IPS in addition to angioembolization. The group that did not undergo embolization of the IPS was used as the control group (n = 10). These groups were compared with regard to the above outcome measures. Blood loss and new lower cranial nerve deficits were reduced in the venous embolization group, although neither measure reached statistical significance. Tumor size correlated with increased intraoperative hypotensive events and longer total hospital stay, and these correlations were statistically significant.
  
  
  CONCLUSIONS
  Preoperative embolization of the IPS is possible in many patients undergoing surgery of the jugular foramen. The addition of venous embolization to the traditional arterial embolization of glomus jugulare tumors adds little additional time or expense to the procedure and facilitates control of bleeding once the jugular bulb has been opened.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, USA.
authors.forename: Frank M
authors.initials: FM
authors.lastname: Warren
authors.forename: Ryan R
authors.initials: RR
authors.lastname: McCool
authors.forename: Jason O
authors.initials: JO
authors.lastname: Hunt
authors.forename: Nan
authors.initials: N
authors.lastname: Hu
authors.forename: Perry P
authors.initials: PP
authors.lastname: Ng
authors.forename: Luke P
authors.initials: LP
authors.lastname: Buchmann
authors.forename: Clough
authors.initials: C
authors.lastname: Shelton
mesh_terms: D000328:Adult; D000368:Aged; D003392:Cranial Sinuses / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D005925:Glomus Jugulare Tumor / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome