title: Incidence of cranial nerve palsy after preoperative embolization of glomus jugulare tumors using Onyx.
abstract: OBJECTIVE
  The resection of glomus jugulare tumors can be challenging because of their inherent vascularity. Preoperative embolization has been advocated as a means of reducing operative times, blood loss, and surgical complications. However, the incidence of cranial neuropathy associated with the embolization of these tumors has not been established. The authors of this study describe their experience with cranial neuropathy following transarterial embolization of glomus jugulare tumors using ethylene vinyl alcohol (Onyx, eV3 Inc.).
  
  
  METHODS
  The authors retrospectively reviewed all cases of glomus jugulare tumors that had been treated with preoperative embolization using Onyx at their institution in the period from 2006 to 2012. Patient demographics, clinical presentation, grade and amount of Onyx used, degree of angiographic devascularization, and procedural complications were recorded.
  
  
  RESULTS
  Over a 6-year period, 11 patients with glomus jugulare tumors underwent preoperative embolization with Onyx. All embolization procedures were completed in one session. The overall mean percent of tumor devascularization was 90.7%. No evidence of nontarget embolization was seen on postembolization angiograms. There were 2 cases (18%) of permanent cranial neuropathy attributed to the embolization procedures (facial nerve paralysis and lower cranial nerve dysfunction).
  
  
  CONCLUSIONS
  Embolizing glomus jugulare tumors with Onyx can produce a dramatic reduction in tumor vascularity. However, the intimate anatomical relationship and overlapping blood supply between these tumors and cranial nerves may contribute to a high incidence of cranial neuropathy following Onyx embolization.
authors: Departments of Neurological Surgery and.
authors: Brandon G
authors: BG
authors: Gaynor
authors: Mohamed Samy
authors: MS
authors: Elhammady
authors: Daniel
authors: D
authors: Jethanamest
authors: Simon I
authors: SI
authors: Angeli
authors: Mohammad A
authors: MA
authors: Aziz-Sultan
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000098:blood supply / Q000601:surgery; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D003389:Cranial Nerve Diseases / Q000453:epidemiology / Q000209:etiology*; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005925:Glomus Jugulare Tumor / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010243:Paralysis / Q000209:etiology; D011145:Polyvinyls / Q000627:therapeutic use*; D012039:Regional Blood Flow; D012189:Retrospective Studies; D014012:Tinnitus / Q000209:etiology
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide