Tympanic paraganglioma

Last revised by Khalid Alhusseiny on 27 Mar 2024

Tympanic paragangliomas (previously known as glomus tympanicum tumors) are the most common middle ear tumors

The term "glomus" was historically used to describe certain types of neuroendocrine tumors arising from paraganglia. The term is, however, imprecise and can be confused with the glomus bodies and tumors that arise from them. It can also be mixed up with glomus tumors of the subcutaneous skin, also referred to as glomangioma.

There is a female predominance (M: F = 1:3); presentation is most common when patients are more than 40 years old 1,2

May be incidental but symptomatic masses produce pulsatile tinnitus, otalgia, or conductive hearing loss 1,3

Tympanic paragangliomas arise from the Jacobson nerve at the cochlear promontory

CT is usually the best modality to assess these masses. 

  • soft tissue mass lateral to the cochlear promontory

  • ossicles may or not be destroyed and may simply be encased

  • surrounding bony destruction may be present in aggressive tumors

  • intact jugular bulb

The Glasscock-Jackson and Fisch classifications of paragangliomas 5 are based on the local extension of the tumor and their effect on mortality and morbidity. Tympanic paragangliomas are considered type A tumor, as they are limited to the middle ear cavity.

Surgical resection is the treatment of choice 4

On imaging consider:

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