Tympanic paraganglioma
Disclosures
- updated 8 Apr 2023:
Nothing to disclose
Updates to Article Attributes
Title
was changed:
Body
was changed:
Glomus tympanicumTympanic paragangliomas (chemodectomas) are the most common middle ear tumour.
Epidemiology
There is a female predominance (M: F = 1:3); presentation is most common when patients are more than 40 years old 1,2.
Clinical presentation
May be incidental but symptomatic masses produce pulsatile tinnitus, otalgia, or conductive hearing loss 1,3.
Pathology
Glomus tympanicumTympanic paragangliomas arise from the Jacobson nerve at the cochlear promontory.
Radiographic features
CT is usually the best modality to assess these masses.
CT
-
soft tissue mass lateral to the cochlear promontory
if large may fill the middle ear cavity, and invade the Eustachian tube or mastoid
ossicles may or not be destroyed and may simply be encased
surrounding bony destruction may be present in aggressive tumours
intact jugular bulb
The Glasscock-Jackson and Fisch classifications of glomus tumours 5 are based on the local extension of the tumour and their effect on mortality and morbidity. Glomus tympanicum Tympanic paragangliomas are considered type A tumour, as they are limited to the middle ear cavity.
Treatment and prognosis
Surgical resection is the treatment of choice 4.
Differential diagnosis
On imaging consider:
-
glomus jugularepermeative destruction of the floor of the middle ear
involving the jugular foramen
presents with a dehiscent jugular bulb
-
pedunculated mass arising from the facial nerve
involving the tympanic segment of the facial nerve
-
no enhancement on post-contrast T1 MRI
See also
-<p><strong>Glomus tympanicum paragangliomas</strong> (<strong>chemodectomas</strong>) are the most common <a href="/articles/middle-ear-tumours">middle ear tumour</a>. </p><h4>Epidemiology</h4><p>There is a female predominance (M: F = 1:3); presentation is most common when patients are more than 40 years old <sup>1,2</sup>. </p><h4>Clinical presentation</h4><p>May be incidental but symptomatic masses produce <a href="/articles/pulsatile-tinnitus">pulsatile tinnitus</a>, otalgia, or <a href="/articles/conductive-hearing-loss">conductive hearing loss</a> <sup>1,3</sup>. </p><h4>Pathology</h4><p>Glomus tympanicum <a href="/articles/paraganglioma-1">paragangliomas</a> arise from the <a href="/articles/jacobson-nerve">Jacobson nerve</a> at the <a href="/articles/cochlear-promontory">cochlear promontory</a>. </p><h4>Radiographic features</h4><p>CT is usually the best modality to assess these masses. </p><h5>CT</h5><ul>-<li>soft tissue mass lateral to the cochlear promontory<ul><li>if large may fill the middle ear cavity, and invade the <a href="/articles/eustachian-tube">Eustachian tube</a> or <a href="/articles/mastoid-part-of-temporal-bone">mastoid</a>-</li></ul>-</li>- +<p><strong>Tympanic paragangliomas</strong> (<strong>chemodectomas</strong>) are the most common <a href="/articles/middle-ear-tumours">middle ear tumour</a>. </p><h4>Epidemiology</h4><p>There is a female predominance (M: F = 1:3); presentation is most common when patients are more than 40 years old <sup>1,2</sup>. </p><h4>Clinical presentation</h4><p>May be incidental but symptomatic masses produce <a href="/articles/pulsatile-tinnitus">pulsatile tinnitus</a>, otalgia, or <a href="/articles/conductive-hearing-loss">conductive hearing loss</a> <sup>1,3</sup>. </p><h4>Pathology</h4><p>Tympanic <a href="/articles/paraganglioma-1">paragangliomas</a> arise from the <a href="/articles/jacobson-nerve">Jacobson nerve</a> at the <a href="/articles/cochlear-promontory">cochlear promontory</a>. </p><h4>Radiographic features</h4><p>CT is usually the best modality to assess these masses. </p><h5>CT</h5><ul>
-<a href="/articles/middle-ear-ossicles">ossicles</a> may or not be destroyed and may simply be encased</li>-<li>surrounding bony destruction may be present in aggressive tumours</li>-<li>intact <a href="/articles/jugular-bulb">jugular bulb</a>- +<p>soft tissue mass lateral to the cochlear promontory</p>
- +<ul><li><p>if large may fill the middle ear cavity, and invade the <a href="/articles/eustachian-tube">Eustachian tube</a> or <a href="/articles/mastoid-part-of-temporal-bone">mastoid</a></p></li></ul>
-</ul><p>The <a href="/articles/glasscock-jackson-and-fisch-classifications-of-glomus-tumours">Glasscock-Jackson and Fisch classifications of glomus tumours</a> <sup>5</sup> are based on the local extension of the tumour and their effect on mortality and morbidity. Glomus tympanicum paragangliomas are considered type A tumour, as they are limited to the middle ear cavity.</p><h4>Treatment and prognosis</h4><p>Surgical resection is the treatment of choice <sup>4</sup>. </p><h4>Differential diagnosis</h4><p>On imaging consider:</p><ul>- +<li><p><a href="/articles/middle-ear-ossicles">ossicles</a> may or not be destroyed and may simply be encased</p></li>
- +<li><p>surrounding bony destruction may be present in aggressive tumours</p></li>
- +<li><p>intact <a href="/articles/jugular-bulb">jugular bulb</a></p></li>
- +</ul><p>The <a href="/articles/glasscock-jackson-and-fisch-classifications-of-glomus-tumours">Glasscock-Jackson and Fisch classifications of glomus tumours</a> <sup>5</sup> are based on the local extension of the tumour and their effect on mortality and morbidity. Tympanic paragangliomas are considered type A tumour, as they are limited to the middle ear cavity.</p><h4>Treatment and prognosis</h4><p>Surgical resection is the treatment of choice <sup>4</sup>. </p><h4>Differential diagnosis</h4><p>On imaging consider:</p><ul>
-<a href="/articles/glomus-jugulare-paraganglioma">glomus jugulare paraganglioma</a><ul>-<li>permeative destruction of the floor of the middle ear</li>-<li>involving the jugular foramen</li>-<li>presents with a <a href="/articles/dehiscent-jugular-bulb">dehiscent jugular bulb</a>-</li>- +<p><a href="/articles/jugular-paraganglioma">jugular paraganglioma</a></p>
- +<ul>
- +<li><p>permeative destruction of the floor of the middle ear</p></li>
- +<li><p>involving the jugular foramen</p></li>
- +<li><p>presents with a <a href="/articles/dehiscent-jugular-bulb">dehiscent jugular bulb</a></p></li>
-<a href="/articles/facial-nerve-schwannoma">facial nerve schwannoma</a><ul>-<li>pedunculated mass arising from the <a href="/articles/facial-nerve">facial nerve</a>-</li>-<li>involving the tympanic segment of the facial nerve</li>- +<p><a href="/articles/facial-nerve-schwannoma">facial nerve schwannoma</a></p>
- +<ul>
- +<li><p>pedunculated mass arising from the <a href="/articles/facial-nerve">facial nerve</a></p></li>
- +<li><p>involving the tympanic segment of the facial nerve</p></li>
-<a href="/articles/congenital-cholesteatoma">congenital cholesteatoma</a><ul><li>no enhancement on post-contrast T1 MRI</li></ul>- +<p><a href="/articles/congenital-cholesteatoma">congenital cholesteatoma</a></p>
- +<ul><li><p>no enhancement on post-contrast T1 MRI</p></li></ul>
-</ul><h4>See also</h4><ul><li><a href="/articles/paragangliomas-of-the-head-and-neck">paragangliomas of the head and neck</a></li></ul>- +</ul><h4>See also</h4><ul><li><p><a href="/articles/paragangliomas-of-the-head-and-neck">paragangliomas of the head and neck</a></p></li></ul>
Updates to Synonym Attributes
Title
was added:
Glomus tympanicum paraganglioma
Slug
was set to
glomus-tympanicum-paraganglioma-1.
Type
was set to
Synonym.
Visible
was set to
false.
Content Type
was set to
Article.
Updates to Primarylink Attributes
Title
was changed:
Type
was set to
PrimaryLink.
Visible
was set to
true.
Content
was set to
40262.
Updates to Link Attributes
Title
was removed:
Type
was removed.
Visible
changed from true to false.
Unable to process the form. Check for errors and try again.