[The endaural approach and surgery of glomus jugulare tumors (5 cases)].

The endaural approach has its in excision surgery of certain forms of jugular glomus tumor. --In the pure, tympanic form, a minimal or extended endaural approach is perfectly suitable. -- In tympano-mastoid forms, without involvement or with minimal involvement of the jugular foramen, a prolonged endaural approach may be used for wider operations involving the whole middle ear and mastoid around a bony aqueduct or an exposed VII. --Nevertheless, in the presence of tympano-jugular or tympano-masto-jugular forms, with marked involvement of jugular foramen, the greatest caution is necessary. It would appear that the endaural route may still be suggested but only for certain tumors, with the express reserve that angiographic studies defining its site and extent are favourable. By virtue of more and more highly developed techniques of exploration (scanner with contrast, films in subtraction) which may be used for measurement and precise localization of the tumor, indications for the type of approach may now be defined with even more precision. --It should be noted that if there is the slightest doubt, the slightest reserve, or the slightest fear that an endaural approach might be inadequate to deal with the situation, it should be definitely avoided with preference for a cervico-retro-auricular or cervicopre and retro-auricular approach, or radiotherapy only, or even abstenstion from operation, with observation. It is only if such rules of good sense and caution are respected that minimal, extended, prolonged endaural approaches will retain a worthy place in the surgical treatment of jugular glomus tumors.