Carbon Dioxide (CO 2 ) Laser Glomus Tympanicum Resection: Hearing Outcomes and Recurrence Rates

Area of Science:

• Otolaryngology
• Neurosurgery
• Oncology

Background:

• Glomus tympanicum (GT) are common benign neoplasms of the temporal bone, originating from neural crest cells.
• Surgical excision is the primary treatment for GT, a vascular tumor located on the promontory.

Purpose of the Study:

• To evaluate surgical and hearing outcomes in patients with middle ear paragangliomas after CO2 laser resection.
• To assess the efficacy and safety of CO2 laser in treating glomus tympanicum.

Main Methods:

• Retrospective review of 15 patients with GT treated with CO2 laser (2014-2021).
• Surgical approaches included canal wall down with reconstruction/obliteration, canal wall up mastoidectomy, and endaural/transcanal.
• Preoperative and postoperative audiometry, symptom evaluation, and otomicroscopic exams were performed.

Main Results:

• Complete tumor removal was achieved in all cases with no recurrence or complications.
• CO2 laser fiber (500-micron) used at 3-4 watts in continuous mode.
• Three patients with significant air-bone gap underwent successful ossicular chain reconstruction, improving hearing.

Conclusions:

• Flexible CO2 laser fiber and specific mastoidectomy techniques (CWD with CWR/MO) are beneficial for GT management.
• CO2 laser resection is a safe, reliable method for GT, offering complete removal with low morbidity and recurrence rates.