Glomus tympanicum paraganglioma

Glomus tympanicum paragangliomas (chemodectomas) are the most common middle ear tumour.

Epidemiology

There is a female predominance (M: F = 1:3); presentation is most common when patients are more than 40 years old .

Clinical presentation

May be incidental but symptomatic masses produce pulsatile tinnitus, otalgia, or conductive hearing loss .

Pathology

Glomus tympanicum paragangliomas arise from the Jacobson nerve at the cochlear promontory.

Radiographic features

CT is usually the best modality to assess these masses.

CT
  • soft tissue mass lateral to the cochlear promontory
  • ossicles may or not be destroyed and may simply be encased
  • surrounding bony destruction may be present in aggressive tumours
  • intact jugular bulb

The Glasscock-Jackson and Fisch classifications of glomus tumours are based on the local extension of the tumour and their effect on mortality and morbidity. Glomus tympanicum paragangliomas are considered type A tumour, as they are limited to the middle ear cavity.

Treatment and prognosis

Surgical resection is the treatment of choice .

Differential diagnosis

On imaging consider:

See also

Siehe auch:
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