Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

A Case Report of Glomus Tympanicum Complicated With Facial Nerve Palsy

Document Type : Case Report

Authors
Christodoulos Dimakis 1
Despoina Beka 1
Eustratios Papageorgiou 1
Nikolaos Tsetsos 2
Alexandros Poutoglidis 2
Athanasia Gortsali 1
Alexandros Nomikos 3
Georgios Karatzias 1
1 Department of Otorhinolaryngology-Head and Neck Surgery, "General Hospital Asklipιeio Voula", Athens, Greece
2 Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
3 Department of pathology, "General Hospital Asklipιeio Voula", Athens, Greece
10.22038/ijorl.2022.64737.3217
Abstract
Introduction:
Generally, glomus tumors are considered tumors of the autonomic system arising from chromaffin cells of the parasympathetic paraganglia of the skull base and neck. Glomus tympanicum is the most common primary tumor of the middle ear cavity and it arises from the paraganglia of the middle ear.
Case Report:
We present a case of glomus tympanicum presented in a 70-year-old woman, complicated with facial nerve palsy which at first sight was misdiagnosed as cholesteatoma. Patient presented in our clinic because of otorrhea, pulsatile tinnitus and hearing loss in the right ear. However, facial nerve function was good in the first examination (40 days before the surgery). Eventually, she treated successfully with a canal wall down mastoidectomy. Technique had been chosen because of the mass size and the involvement of external auditory canal, after a discussion with the patient.
Conclusions:
Although histologically benign, glomus tympanicum is slow growing and destructs adjacent tissues potentially. The two most common complaints are hearing loss (conductive) and pulsatile tinnitus. These neoplasms are more common in women and they can be diagnosed by CT or MRI scan. It is of high importance physicians suspect a glomus tumor when patient ‘s clinical findings are hearing loss and pulsatile tinnitus and use an intravascular agent in imaging so that the differential diagnosis will be supported.
Keywords
Facial nerve paralysis
Glomus tympanicum
Paraganglioma
  1. VR Appannan, MK Md Daud. Glomus tympanicum. Malays Fam Physician 2018; 13(1): 45-48,.
  2. T. B. R. A. H. D. Fang, Benign Neoplasia, Paragangliomas-Glomus Tympanicum, Berlin: Springer; 2013.
  3. A. Wackym, J. J. B. Snow. Ballenger's Otorhinolaryngology: Head and Neck Surgery, 18th ed. Chaoyang: People's Medical Publishing House; 2016:
  4. Hinerman RW, RJ Amdur, CG Morris, Kirwan J, Mendenhall WM. Definitive radiotherapy in the management of paragangliomas arising in the head and neck: a 35-year experience. Head Neck, 2008; 30(11):1431-1438.
  5. R. Asad Ikram. www.ncbi.nlm.nih.gov," 09 09 2021. [Online]. Available: https://www. ncbi.nlm.nih. gov/books/NBK549834/.
  6. Hosalkar RM. Carotid Body Paraganglioma, Annals of Maxillofacial Surgery, 2019; 9(2):            423-428,.
  7. C. Y. S. e. a. Offergeld C, "Head and neck paragangliomas: clinical and molecular genetic classification.," Clinics. 2012, vol. 67, no. 19, 2012.
  8. J. F.-d. J. O. D. Thomas, "www.ncbi.nlm.nih.gov," 30 08 2021. [Online]. Available: https://www.ncbi.nlm.nih. gov/books/ NBK560489/. [Accessed 14 01 2022].
  9. Semaan MT, Megerian CA. Current assessment and management of glomus tumors. Current opinion in otolaryngology & head and neck surgery. 2008 Oct 1;16(5):420-6.
  10. Kerckhoffs KG, Kommer MB, Van Strien TH, Visscher SJ, Bruijnzeel H, Smit AL, et al. The disease recurrence rate after the canal wall up or canal wall down technique in adults. The Laryngoscope. 2016 Apr;126(4):980-7.

 

  1. Mahadevaiah A, Parikh B, Kumaraswamy K. Surgical management of glomus tympanicum tumor. Indian Journal of Otolaryngology and Head & Neck Surgery. 2007 Mar;59(1):5-8.
  2. Carlsen CS, Godballe C, Krogdahl AS, Edal AL. Malignant vagal paraganglioma: report of a case treated with embolization and surgery. Auris Nasus Larynx. 2003 Dec 1;30(4):443-6.
  3. Pitiakoudis M, Koukourakis M, Tsaroucha A, Manavis J, Polychronidis A, Simopoulos C. Malignant retroperitoneal paraganglioma treated with concurrent radiotherapy and chemotherapy. Clinical Oncology. 2004 Dec 1;16(8):580-1.
  4. Sismanis AA. Otolaryngology - Head and Neck Surgery, 1st, Athens: Parisianou; 2011.
Iranian Journal of Otorhinolaryngology
Volume 34, Issue 6
November and December 2022
Pages 327-331