Glomus tympanicum.A 48-year-old woman came to the office complaining of a 6-month history of pulsatile tinnitus and mild hearing loss in the left ear. She reported episodes of aural fullness and pressure in the same ear during the previous 2 years. On examination under the microscope, a red pulsatile pulsatile /pul·sa·tile/ (pul´sah-til) characterized by a rhythmic pulsation. pul·sa·tile adj. Undergoing pulsation. pulsatile characterized by a rhythmic pulsation. mass was seen behind the tympanic membrane (figure). The vascular mass abutted the tympanic membrane and appeared to invade it at the posteroinferior quadrant. The tumor blanched during pneumatic otoscopy. The anterosuperior quadrant appeared to be free of disease. The Weber test lateralized to the involved ear, and air conduction was equal to bone conduction with the 512-Hz tuning fork. 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 revealed pulsatile tinnitus that was synchronous with the patient's heartbeat. 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. (CT) was ordered in order to differentiate 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 from a glomus jugulare. In this case, no erosion was present in the floor of the middle ear and the jugular bulb, a finding that allowed us to rule out the possibility of a glomus jugulare. CT revealed that the tumor filled the middle ear, extended to the mastoid antrum, and was wrapped around the ossicular os·si·cle n. A small bone, especially one of the three bones of the middle ear. [Latin ossiculum, diminutive of os, bone; see ost- in Indo-European roots. chain. [FIGURE OMITTED] The tumor was successfully removed via a postauricular approach. The middle ear was cleared, and the feeding vessel in the hypotympanum was cauterized. The tympanic membrane was grafted, and the facial nerve and the ossicular chain were preserved. From the House Ear Clinic and the Department of Otolaryngology-Head and Neck Surgery, 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. John W. House, MD; Jose N. Fayad, MD |
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