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Glomus Jugulare - ITF Type - A Approach

Glomus Jugulare - ITF Type - A Approac

Fig.1 Post Auricular Incision From Temporal Region To Cricoid

Fig.2 Skin flap was raised superficial to temporalis and sternomastoid muscles. Anteriorly based myoperiosteal flap was raised over the mastoid (for blind closure).

Fig.3 EAC is divided at the bony and cartilagenous junction. The skin was dissected off the cartilage (for blind closure)

Fig.4 Elevated skin of the cartilagenous canal was everted and closed (first layer of blind sac)

Fig.5 Anteriorly based myoperiosteal layer was rotated (arrow) and sutured to the cartilage of the canal (as a second layer of blind sac closure)

Fig.6 Neck is dissected and ECA, ICA, IJV, and cranial nerves VII, X, XI & XII are exposed.

Fig.7 Subtotal petrosectomy done. Facial nerve is decompressed from geniculate ganglion to its bifurcation in the parotid gland.

Fig.8 Decompressed facial nerve is rerouted anteriorly to expose the area of jugular bulb.

Fig.9 Decompressed facial nerve is rerouted anteriorly to expose the area of jugular bulb.

Fig.10 MR angio shows no blood flow on the side of tumour (yellow arrow). Tumour can grow inside the lumen of the jugular bulb and occlude it completely.

Fig.11 Picture shows tumour inside IJV.

Fig.12 Decompressed facial nerve is rerouted anteriorly to expose the area of jugular bulb.

Fig.13 Closure. Dead space is filled with free fat.

Fig.14 Closure. The Temporalis muscle is rotated and sutured to the sternomastoid muscle.

The Heart Of Clinic

Dr. C. Rayappa MBBS, DLO, FRCS(Edin)

SENIOR CONSULTANT

+91 44 3315 1105

Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)

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The Heart Of Clinic

Dr. C. Rayappa MBBS, DLO, FRCS(Edin)

SENIOR CONSULTANT

+91 44 3315 1105

Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)

Mithun Das

03:35 18 Mar 23

Its a pleasure experience with Dr. Rayappa C. We came for my wife thyroid nodules operation and testing for cancer malignancy. Doctor taken care everything with my previous diagnosis report and suggest to surgery half of thyroid infected lob.After this operation we got biopsy report that indicate still cancer not affected.Thanks to doctor and wishes him all the very best.

Saima Hasin

07:07 13 Mar 23

A sincere and dedicated doctor. He treated my husband for Oral Cancer. He gave his best efforts to overcome the disease. With patience and sincerity he handled the post surgery stages. We are so thankful to him. Expressing our gratitude to Almighty Allah and of course to Dr.Rayappa for his recovery .

Reyad Alam

16:49 16 Feb 23

Just saying ‘Thank you’ will not justify what Dr. Rayappa sir has done for us.My mom was having difficulty in breathing for merely 2 years due to thyroid enlargement.So we consulted Dr.Rayappa and he asked us to do surgery as soon as possible. It was hard for us to take the decision since a lot of risks was involved but we went ahead with it.Post surgery - My mom feels so energetic and alive, which she never felt before. Can breathe better, can talk, and just recovered in 2 days. The surgery was a success and Dr. Rayappa and his team took great for us throughout. We can’t describe the joy and happiness we’re filled with to see my mother so healthy.We give our heartfelt gratitude to Dr.Rayappa sir and his team.Dr. Rayappa is a great Otolaryngologist and we highly recommend him.

Poojha Shri

15:49 06 Feb 23

This is Vanamadevi patient of Dr.Rayappa. Dr sir is a God in the form of human. Highly blessed to be treated by him.Gave us hope in a hopeless situation. Very good service by the whole team. Thank you.

Rajiya Sultana

08:47 06 Jan 23

I am very much satisfied in your treatment. Dr.Rayappa sir is a very kind hearted man and a great doctors ever seen in my life.May Allah bless him and his family.

Glomus Jugulare - ITF Type - A Approach