Supra/ para condylar approach for resection of GLOMUS jugular tumor

Background Glomus jugulare tumors are rare, highly vascular paragangliomas arising from the jugular bulb. Their intimate relationship with the lower cranial nerves, internal carotid artery, and sigmoid sinus makes complete resection technically demanding. The supra/paracondylar approach provides controlled, stepwise exposure of the jugular foramen while minimizing bony drilling and preserving critical neurovascular structures. Objective To demonstrate the surgical technique, anatomical landmarks, and key decision points of the supra/paracondylar approach for resection of a glomus jugulare tumor. Methods: We present an illustrative case of a patient with glomus jugulare tumor. The operative video details patient positioning, skin incision, mastoidectomy with identification of the sigmoid sinus and facial nerve, infralabyrinthine dissection, and transcondylar drilling to expose the jugular bulb. Tumor devascularization, piecemeal resection, and management of the lower cranial nerves (IX–XII) are demonstrated. Strategies for controlling venous bleeding and protecting the internal carotid artery are highlighted. Results Gross-total resection was achieved with preservation of facial nerve function. The patient's postoperative course and cranial nerve outcomes are reviewed. Conclusion The supra/paracondylar approach offers a versatile, extradural corridor to glomus jugulare tumors, balancing maximal tumor access against lower cranial nerve preservation. This video illustrates the critical steps and pitfalls of the technique.