Efficacy and Safety of Preoperative Embolization in Glomus Jugulare Tumors: A Systematic Review and Meta-analysis of Clinical Outcomes and Complications

• Published in: Cardiovascular and interventional radiology 2024-04, Vol.47 (4), p.416-431
• Main Authors: Ghanaati, Hossein, Zarei, Diana, Issaiy, Mahbod, Ghavami, Nafiseh, Shakiba, Madjid, Zebardast, Jayran, Abbastabar, Hedayat, Jalali, Amir Hossein, Firouznia, Kavous
• Format: Article
• Language: English
• Subjects: Cardiology; Cardiovascular system; Clinical outcomes; Confidence intervals; Embolisation (arterial); Embolization; Facial nerve; Hemorrhage; Heterogeneity; Imaging; Medicine; Medicine & Public Health; Meta-analysis; Nuclear Medicine; Paraganglioma; Patients; Radiology; Review; Statistical analysis; Tumors; Ultrasound; Vagus nerve
• ISSN: 0174-1551; 1432-086X; 1432-086X
• DOI: 10.1007/s00270-024-03687-z

Purpose This study aims to provide a comprehensive review of the clinical benefits, complications, and safety profile associated with preoperative embolization in Glomus jugulare tumors (GJTs). Materials and Methods A comprehensive search in PubMed, Embase, and Web of Science was conducted for English articles published up to March 2023, focusing on GJTs and preoperative embolization. Included studies involved patients over 18 with GJTs. We excluded studies that explored embolization methods other than the standard endovascular approach, as well as studies involving paragangliomas that did not provide specific data related to GJTs. Key variables such as hemorrhage volume and surgical time, as well as clinical outcomes, were analyzed. Data were analyzed using a random-effects model meta-analysis, assessing heterogeneity with the I 2 statistic. Results This review encompasses 19 studies with a total of 328 patients. The studies incorporated into our meta-analysis display considerable differences and inconsistencies in their data. The findings of the meta-analysis show a mean hemorrhage volume of 636 ml (95% confidence interval (CI) 473–799) following preoperative embolization, and a mean surgical duration of 487 min (95% CI 350–624). The study also notes potential complications: facial nerve deficits occurred in 20% of cases (95% CI 11–32%), and vagal nerve deficits in 22% (95% CI 13–31%). Conclusion This study suggests that preoperative embolization could decrease surgery duration and blood loss, but emphasizes the importance of evaluating risks like nerve damage. However, the generalizability of these findings is restricted due to the diversity of available data. Graphical Abstract