目的探讨颈静脉球瘤的临床特点、诊断要点及巨大颈静脉球瘤的手术治疗方法。方法回顾性分析2000至2009年深圳市第二人民医院及山东大学齐鲁医院耳鼻咽喉科收治的8例颈静脉球瘤的病例资料。结果 8例患者中,男5例,女3例;33～62岁;均为单耳病变,左耳2例,右耳6例;主要临床症状为搏动性耳鸣、声音嘶哑、听力下降和面瘫。临床表现结合CT、MRI等影像学检查可明确诊断。所有病例均经术后病理证实。按1979年Fisch分型,A型0耳,B型1耳,C型1耳,D1型4耳,D2型2耳。均给予手术治疗,2例行单纯乳突根治术,6例行颞颈联合入路彻底切除肿瘤。术中2例出现脑脊液漏均经硬脑膜修补后治愈;2例术后面瘫,1例经治疗后缓解,1例为永久性;原有声音嘶哑、搏动性耳鸣缓慢消失。随访6例,单纯乳突根治术2例中,1例随访5年未复发,1例失访;余5例中,有1例术后第2年复发,给予放射治疗;2例随访7年,1例3年,1例2年,均未复发。结论颈静脉球瘤易误诊;诊断主要根据病史、临床及影像学检查,其中影像学对确诊起重要作用。手术切除是目前治疗颈静脉球瘤最好的方式,入路的选择对于手术的成功起决定性作用。 Objective To investigate the clinical features, diagnosis points, and surgical treatment of massive jugular bulb tumors of jugular bulbaries. Methods Retrospectively analyzed the data of 8 cases of jugular glomus tumors treated by Department of Otolaryngology from the Second People’s Hospital of Shenzhen and Qilu Hospital of Shandong University from 2000 to 2009. Results Among 8 patients, 5 were males and 3 were females; 33 to 62 years old; all had monaural lesions, 2 left ears and 6 right ears; the main clinical symptoms were pulsatile tinnitus, hoarseness, hearing loss and facial paralysis. . Clinical manifestations combined with CT, MRI and other imaging tests can confirm the diagnosis. All cases were confirmed by postoperative pathology. According to the 1979 Fisch classification, there are 0 ear type A, 1 ear type B, 1 ear type C, 4 ear type D1, and 2 ear type D2. All patients were given surgical treatment. Two patients underwent radical mastoidectomy. Six patients underwent complete surgical resection of the tumor. Two cases of intraoperative cerebrospinal fluid leakage were cured after dural repair; 2 cases of facial paralysis, 1 case resolved after treatment, 1 case was permanent; original hoarseness, pulsatile tinnitus slowly disappeared. Follow-up was performed in 6 patients. Of the 2 patients who underwent mastoidectomy alone, 1 patient was followed up for 5 years without recurrence and 1 patient was lost. Among the remaining 5 patients, 1 patient relapsed after the second year and was treated with radiation therapy; 2 patients were followed up for 7 years. , 1 case of 3 years, 1 case of 2 years, no recurrence. Conclusion Jugular glomus tumors are often misdiagnosed. The diagnosis is mainly based on medical history, clinical and imaging examinations, and imaging plays an important role in the diagnosis. Surgical resection is currently the best way to treat jugular glomus tumors, and the choice of approach plays a decisive role in the success of surgery.