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Gamma Knife Radiosurgery for Glomus Jugulare

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 A Glomus Jugulare Tumor: What Is It?

A Glomus Jugulare Tumor
A Glomus Jugulare Tumor

The paraganglionic cells in the jugular foramen of the temporal bone at the base of the skull give rise to an uncommon, usually benign, but locally aggressive vascular Tumor called a Glomus Jugulare Tumor. These cancers belong to a larger class of Tumors called paragangliomas, which come from the autonomic nerve system and are intimately linked to the body’s control of blood pressure and other autonomic processes.

Glomus Jugulare Tumors are generally benign (non-cancerous), but they can be extremely infiltrative, growing slowly but steadily, and can cause serious symptoms by infiltrating nearby structures like the middle ear, cranial nerves, and neck vascular structures.

Origin and Anatomy

The internal jugular vein and the cranial nerves IX (Glossopharyngeal), X (Vagus), and XI (Accessory) leave the skull through the jugular foramen, a crucial opening near the base of the skull. The paraganglionic cells connected to the jugular bulb, a venous structure in this area, are usually the source of Glomus Jugulare Tumors.

Glomus Jugulare Tumor Symptoms

Glomus Jugulare Tumour Symptoms
Glomus Jugulare Tumour Symptoms

The Tumor may compress or affect nearby neurovascular structures as it grows, resulting in a range of symptoms, such as:

  • Loss of hearing (often pulsatile)
  • Ringing in the ears, or tinnitus
  • Ear discharge or fullness
  • Changes in voice or hoarseness
  • Having trouble swallowing
  • Weakness or paralysis of the face
  • Unbalanced or lightheaded
  • Palsy of the lower cranial nerves

More severe neurological impairments may result from advanced Tumors that spread into the brainstem or higher spinal cord.

Diagnosis

A combination of imaging tests and clinical examinations is usually used to make the diagnosis, including:

  1. Magnetic resonance imaging, or MRI, aids in determining the tumor’s size and vascularity.
  2. A computed tomography (CT) scan is helpful in assessing bone degradation.
  3. Angiography: To view the blood supply and potentially embolise feeding vessels, it can be performed prior to surgery or before radiosurgery.
  4. Tests of audiometry: To evaluate hearing ability.
  5. Because of the vascular nature and normal radiologic appearance, a biopsy is rarely necessary.

Options for Treatment

The size, location, symptoms, age, and overall health of the patient all influence the course of treatment. The primary choices consist of:

  1. A remark (“Watchful Waiting”)

Imaging may be used to periodically check for small, asymptomatic Tumors in elderly or fragile patients.

  1. Resection via Surgery

Surgery has historically been the primary course of treatment, particularly for younger patients whose Tumors are easily accessible. However, because vital blood arteries and nerves are so close together, surgery is technically difficult and may result in haemorrhage, injury to the cranial nerve, and other problems.

  1. Treatment with Radiation

Tumor growth can be stopped or slowed via stereotactic radiosurgery or conventional radiation therapy.

Radiosurgery with Gamma Knife for Glomus Jugulare

Gamma Knife Radiosurgery Glomus Jugulare
Gamma Knife Radiosurgery Glomus Jugulare

Gamma Knife Radiosurgery (GKRS) is one of the most promising and less invasive methods for treating Tumors of the Glomus Jugulare. It works particularly well to prevent Tumor growth while maintaining brain function.

Gamma Knife Radiosurgery: What is it?

Gamma Knife Radiosurgery
Gamma Knife Radiosurgery

Gamma Knife is a type of stereotactic radiosurgery, radiosurgery protects the surrounding normal tissues while precisely delivering high-dose, targeted radiation to the Tumor target.  

Gamma Knife Advantages for Glomus Jugulare Tumors:

  • Non-invasive: No general anaesthesia or incision is necessary.
  • Function preservation: A great way to preserve nerve integrity, hearing, and swallowing.
  • High Tumor control rate: Research indicates that over 90% of Tumors are under control.
  • Short recovery period: Patients frequently return to their regular activities in a few of days.
  • Safe for inoperable cases: Perfect for patients with comorbidities or advanced age who are not suitable candidates for surgery.
  • Outpatient procedure: Most of the time, no hospital stay is required. 

Examples of Gamma Knife Indications:

  • Tumors that are smaller than 3–3.5 cm.
  • After surgery, patients with recurring or persistent Tumors.
  • Unsuitable patients for open surgery.
  • Tumors that affect important neurovascular structures.

Long-Term Prospects and Following

Because Glomus Jugulare Tumors develop slowly, long-term control and a high quality of life are possible with advanced treatment methods like Gamma Knife Radiosurgery. Every six to twelve months, a routine imaging follow-up (usually an MRI) is advised to check for any progression or recurrence.

In conclusion

Despite being uncommon and difficult to treat, glomus jugulare Tumors can be successfully treated by a multidisciplinary team that includes radiation oncologists, neurosurgeons, ENT experts, and radiologists. By providing a safe, efficient, and minimally invasive method that guarantees Tumor control with little morbidity, Gamma Knife Radiosurgery has completely changed the way that therapy is approached.

Sources:

  1. https://www.ncbi.nlm.nih.gov/books/NBK560489/
  2. https://pubmed.ncbi.nlm.nih.gov/32809324/
  3. https://pmc.ncbi.nlm.nih.gov/articles/PMC9843021/
  4. https://medlineplus.gov/ency/article/001634.htm
  5. https://www.sciencedirect.com/science/article/pii/S2214751919303202
  6. https://patient.info/doctor/glomus-jugulare-Tumours
  7. https://journals.lww.com/neur/fulltext/2008/56010/gamma_knife_radiosurgery_for_glomus_jugulare.12.aspx
  8. https://thejns.org/view/journals/j-neurosurg/126/5/article-p1488.xml
  9. https://journals.lww.com/neurosurgery/abstract/2006/11000/gamma_knife_radiosurgery_for_glomus_jugulare.7.aspx
  10. https://journals.lww.com/neurosurgpraconline/Pages/instructionsforauthors.aspx

You May Also Know Related to Gamma Knife
FAQ’s

Gamma Knife uses 192–201 precisely focused beams of gamma rays that converge at a single target point in the brain. This high dose of radiation damages the DNA of abnormal cells, stopping their growth or causing them to shrink, while minimizing exposure to nearby healthy tissue.

No, Gamma Knife is not a traditional surgery. It is a non-invasive outpatient procedure performed without any incision, stitches, or general anesthesia in most cases.

Gamma Knife is commonly used for:

Brain tumors (benign and malignant)
Metastatic brain lesions
Arteriovenous malformations (AVMs)
Trigeminal neuralgia
Acoustic neuromas (vestibular schwannomas)
Pituitary tumors
Certain functional disorders (like tremors)

The procedure is generally painless. Patients may feel mild pressure while the head frame (if used) is applied or may experience slight discomfort from anesthesia injections, but the treatment itself is not painful.

Depending on the condition and treatment plan, Gamma Knife may take 30 minutes to 3 hours. Most patients go home the same day.

Common side effects are usually mild and temporary, including:

Headache
Nausea
Fatigue
Mild scalp swelling or tenderness at the frame site
Rarely, some patients may experience delayed radiation effects such as brain swelling or radiation necrosis.

Most patients can return to their normal routine within 24–48 hours after the procedure.
You may feel mild fatigue for a few days.
Follow-up imaging is usually required after 1 year.

Gamma Knife has a high success rate and has been used worldwide for decades. Its effectiveness depends on the condition treated, size and location of the lesion, and overall patient health. In many cases, it offers results comparable to open surgery with fewer risks.

Yes, in some cases Gamma Knife treatment can be repeated if the disease recurs or if new lesions develop.

Yes. Gamma Knife is considered one of the safest and most precise forms of radiosurgery, with millions of patients treated globally and extensive clinical data supporting its use.

Eligibility depends on factors such as:

Size and location of the lesion
Overall health and age
Whether open surgery is too risky
A neurosurgeon and radiation oncologist will decide if Gamma Knife is the best option for you.

A detailed MRI or CT scan is performed to map the brain.
A lightweight head frame or mask is used for accuracy.
Your doctors plan the radiation dose and target areas using specialized software.

Local anesthesia is given if a head frame is used.
General anesthesia is usually not required, except for children or patients unable to remain still.

Costs vary depending on hospital, city, and condition treated. On average, Gamma Knife in India ranges from ₹1.5 lakh to ₹4.5 lakh. It is usually more affordable compared to treatment in Western countries. At AIIMS Delhi, it is much more affordable around ₹75,000 which makes it affordable for the patients in need.

AIIMS Delhi is one of the leading centres for Gamma Knife in India.

AIIMS uses the latest Gamma Knife Perfexion system.

It has successfully treated thousands of patients for brain tumors, blood vessel problems, and even eye cancers.

The treatment is done by expert neurosurgeons such as Dr. Deepak Agrawal and team.

Clinic timings for Gamma Knife OPD at AIIMS Delhi: Monday & Friday, 8:00 AM – 9:00 AM.

Cost is around ₹75,000 and is subsidized compared to private hospitals.

The whole procedure is usually done in one day:

  • Consultation & Planning – Doctors review your scans and decide the treatment.
  • Head Frame/Mask – A lightweight frame or mask is placed to keep your head still.
  • Imaging – MRI/CT scans are done to locate the exact target.
  • Treatment Planning – Specialists plan the dose and direction of radiation.
  • Gamma Knife Treatment – You lie on the machine; painless radiation beams treat the target (30 mins–3 hrs).
  • Recovery & Discharge – The frame is removed, and most patients go home the same day.
  • Follow-up – MRI after a few months to check results.

Before you get a treatment date, you need to complete a few steps:

  • OPD Registration – Visit the Neurosurgery OPD (Gamma Knife clinic at AIIMS, Mon & Fri 8–9 AM) and register.
  • Consultation with Doctor – Meet the neurosurgeon who will check your reports, MRI/CT scans, and medical history.
  • Investigations – Sometimes fresh MRI/CT or blood tests are needed for treatment planning.
  • Medical Fitness – Basic checks like blood pressure, sugar, heart condition, etc.

Financial/Insurance Approval –

  1. If using Ayushman Bharat or government schemes, you need approval papers.
  2. If self-paying, you will be given the estimated cost (~₹75,000 at AIIMS).
  • Consent & Admission Slip – Once doctors confirm you are fit and formalities are done, you sign the consent form.
  • Treatment Date Allotment – A date is given for your Gamma Knife procedure.

Once you receive your Gamma Knife date, you’ll need to do a few simple things before the procedure:

  • Admission Process – Report to AIIMS on the morning of your procedure and complete admission at the Neurosurgery ward/Daycare.
  • Paperwork – Carry your OPD slip, MRI/CT films, blood test reports, admission slip, and ID proof. If you are covered under Ayushman Bharat/insurance, keep those approval papers ready.
  • Consent Forms – You (or a family member) will sign consent for the procedure and anesthesia.
  • Medical Check-up – Doctors will check your BP, sugar, heart rate, and do a quick physical exam.
  • Fasting – Usually, you will be asked to not eat or drink for 6 hours before the procedure.
  • Pre-Procedure Prep – An IV line may be put, and medicines (sedation/antibiotics if needed) are given.
  • Treatment – You are then taken to the Gamma Knife room for frame/mask placement, imaging, and treatment.

After the procedure, you’ll be observed for a few hours and most patients are discharged the same day or next morning.

Urea & creatinine

No, You can have light breakfast.

Yes, you can take the medicine and then come for the treatment.

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