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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 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 revealed pulsatile tinnitus that was synchronous with the patient's heartbeat. High-resolution computed tomography (CT) was ordered in order to differentiate a glomus 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 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, Los Angeles.

John W. House, MD; Jose N. Fayad, MD
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Title Annotation:OTOSCOPIC CLINIC
Author:Fayad, Jose N.
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Geographic Code:1USA
Date:Sep 1, 2005
Words:260
Previous Article:It is time for Otolaryngologists to perform EGD.
Next Article:Nasopharyngeal teratoma in an adult.
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