Glomus jugulare.We evaluated a 28-year-old woman who complained of "recurrent infections." She reported that she had experienced 8 episodes during the preceding year. The infections were accompanied by pain, dizziness, and pressure in the ear. She said she was not aware of any hearing loss, but she had noted some pulsatile tinnitus during the preceding few weeks. Examination revealed the presence of a vascular mass in the inferior middle ear (figure). A Weber test lateralized to the involved ear, and air conduction was superior to bone conduction with the 512 tuning fork, in both ears. Auscultation auscultation Procedure for detecting certain defects or conditions by listening for normal and abnormal heart, breath, bowel, fetal, and other sounds in the body. The invention of the stethoscope in 1819 improved and expanded this practice, still very useful despite the with a Toynbee tube revealed that the pulsatile tinnitus was synchronous with her heartbeat. The work-up involved an attempt to determine if the vascular mass was a glomus glomus /glo·mus/ (glo´mus) pl. glom´era [L.] 1. a small histologically recognizable body composed of fine arterioles connecting directly with veins, and having a rich nerve supply. 2. tympanicum or a glomus jugulare. We have found that high-resolution computed tomography high-resolution computed tomography Imaging CT at slice–collimation scan interval widths of ≤ 4 mm, which is narrower than the usual 1-3 cm interval 'slices' obtained in conventional CT imaging. Cf Spiral computed tomography. can differentiate the two types of glomus tumors. Careful inspection of the floor of the middle ear and the jugular jugular /jug·u·lar/ (jug´u-lar) 1. cervical. 2. pertaining to a jugular vein. 3. a jugular vein. jug·u·lar adj. bulb revealed erosion. The tumor extended to the posterior wall of the carotid artery. The patient underwent successful removal of the tumor through a modified infratemporal approach. Her facial nerve as well as cranial nerves IX, X, and XI were preserved. John W. House, MD; Jose N. Fayad, MD From the House Ear Clinic and the Keck School of Medicine, University of Southern California The U.S. News & World Report ranked USC 27th among all universities in the United States in its 2008 ranking of "America's Best Colleges", also designating it as one of the "most selective universities" for admitting 8,634 of the almost 34,000 who applied for freshman admission , Los Angeles. |
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