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GLOMUS JUGULARE TUMOR

Glomus Jugulare Tumors are the most common tumors of the middle ear. They arise from Glomus Bodies located within the ear and are very vascular with a blood supply derived from the External Carotid and Internal Carotid Arteries. Glomus Jugulare Tumors are slow growing and are much more common in women.

SYMPTOMS

The symptoms of a Glomus Jugulare Tumor include:
  • Hearing loss with
  • Pulsatile tinnitus (ringing in the ear),
  • Vertigo (dizziness)
  • Ear pain
  • Weakness of swallowing, gagging, shrugging shoulders and tongue movement

DIAGNOSIS

Physical Examination

A comprehensive physical examination will identify hearing loss and neurological deficits relating to damage to Cranial Nerves 9, 10, 11 & 12 such as swallowing, gagging, shrugging shoulders and tongue movement.

Neurophysiological tests for hearing (audiometry) and balance (vestibular) function may be helpful to document damage to these structures.

A red/blue pulsatile mass behind the tympanic membrane is usually seen on examination of the ear.

CT or MRI Scans show a vascular lesion in the region of the Middle Ear and Skull Base.

Blood Chemistry testing for catecholamines and 24 hour urine collection for vanillylmandelic acid, metanephrines, and total catecholamines (to assess catecholamine secretion) should also be performed.

TREATMENT

Glomus Jugulare Tumors require a comprehensive approach that includes medical, surgical and radiation therapy.

Medical Therapy

Medical therapy is useful for tumors that actively secrete catecholamines and is appropriate for palliation or as adjunctive treatment prior to surgery. "Alpha and beta blockers" are important medications to employ before surgery in order to block the potential lethal blood pressure lability and Heart arrhythmias that may occur with manipulation of the tumor which releases Catecholamines into the blood stream.

Surgery

Glomus Jugulare Tumors are very vascular, often requiring pre-operative embolization of the blood supply to the tumor. Surgical treatment is best accomplished by an experienced Skull Base Tumor Team of specialists including Neurosurgery, Neuro-otology, Head & Neck Cancer Surgeon, Vascular Surgery and Craniofacial Plastic Surgery.

The potential complications of surgery include: persistent leakage of Cerebrospinal Fluid (CSF) from the ear, facial paralysis due to damage to the 7th Cranial Nerve (that controls face movement including eye closing), impaired facial sensation resulting from injury to the 5th Cranial nerve branches and hearing loss on the operated side.

Glomus Jugulare Tumors have a significant risk to recurrence (even though the surgery may have been quite successful) potentially necessitating one or more additional operations.

Radiation Therapy

Radiation Therapy can be a useful adjunct to relieve symptoms and stop growth, in spite of persistent tumor mass.


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This page last edited on 2/19

All content ©2016 by Neurosurgical Consultants, P.A.
Author, Martin L. Lazar, MD, FACS
All Rights Reserved. See Usage Notices.