[Diagnosis and therapy of glomus tympanicum and glomus jugulare tumors].
OBJECTIVE
To report on a series of patients with glomus tympanicum or glomus jugulare tumors, and to focus on its diagnosis, treatment, and outcomes.


METHODS
Ten patients with glomus tympanicum or glomus jugulare tumors at Peking Union College Hospital during a 17-year period were reviewed retrospectively.


RESULTS
There were 7 patients with glomus tympanicum, 3 with glomus jugulare tumors, 1 patient with familial paraganglioma and 1 with functioning glomus jugulare tumors. The most common presenting symptoms were pulsatile tinnitus and hearing loss. Other symptoms included facial nerve paralysis, vertigo, otalgia, dysphagia, hoarseness, throat sore, episodic hypertension with headaches and tachycardia. The most common physical sign was a vascular middle ear mass. The other physical signs included Brown sign, upper neck mass, pharyngeal plump, Collet-Sicard syndrome, Homer's syndrome as well as deficit of cranial nerve V. The radiographic evaluation included computed tomograph (9 cases), angiography (4 cases) and magnetic resonance imaging (1 case). Eight patients initially refered to ENT department, and 2 patients initially consulted neurology or endocrinology specialists. The treatment included preoperative embolization in 2 cases, simple surgery in 4 cases and surgery followed by radiation therapy in 6 cases. No significant complications occurred. Nine of the 10 patients were followed up, but 1 was lost. The mean follow-up time was 12 years (ranged, 2-19 years). No tumor recurrence occured in the 6 cases with total tumor removal. Three cases with subtotal tumor resection had no tumor progression.


CONCLUSIONS
The diagnosis and treatment of glomus tympanicum and glomus jugulare tumors is particularly challenging. Typical clinical manifestations and radiographic evaluation should be considered together to establish the diagnosis. The primary treatment for glomus tympanicum is surgery, if necessary, followed by radiotherapy. Subtotal tumor resection followed by radiation yields satisfying outcome for glomus jugulare tumors.
Liu
Jian-feng
JF
Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Medical Academy, Beijing 100005, China.
Ni
Dao-feng
DF
Gao
Zhi-qiang
ZQ
Xu
Chun-xiao
CX
Li
Wu-yi
WY
Chen
Xing-ming
XM
D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005925:Glomus Jugulare Tumor / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D043604:Glomus Tympanicum Tumor / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome