Boon Han Kevin Ng1,2 and Ing Ping Tang1,2*
1ORL HNS Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Sarawak, Malaysia
2ORL HNS Department, Sarawak General Hospital, Kuching, Sarawak, Malaysia
Received: 03 June, 2017; Accepted: 24 June, 2017; Published: 24 June, 2017
Ing Ping Tang, University Malaysia Sarawak (UNIMAS), Jalan Datuk Mohd Musa, 94300 Kota Samarahan, Sarawak, Malaysia, Tel: +60126281537; E-mail:
Kevin Ng BH, Tang IP (2017) Glomus Tympanicum: A rare case of a painful bleeding ear. Arch Otolaryngol Rhinol 3(3): 059-060. DOI: 10.17352/2455-1759.000047
© 2017 Kevin Ng BH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Glomus tumor; Glomus tympanicum. Middle ear tumor
Glomus tympanicum is a rare tumor of the middle ear which typically present with pulsatile tinnitus, hearing loss and bleeding. Examination may reveal a vascular mass which bleed on contact. Imaging is important prior to surgical resection.
Statement of the problem: Here we present a rare case of a young man who presented with left ear bleeding and otalgia.
Result: Examination and imaging showed a vascular mass in the left external ear canal, left middle ear and involving the surrounding structures.
Conclusion: A differential of glomus tympanicum must be considered in cases which present with bleeding left external auditory canal mass and otalgia, although the most common presentations are hearing loss and tinnitus.
Glomus tumors are benign lesions of the middle ear which are slow growing in nature. They are the most common primary neoplasm of the middle ear . Glomus tumor arises from abnormal growth of the paraganglion cells. The head and neck region represent the commonest area where extra adrenal paraganglioma also known as glomus tumors are found . Patients may present with bleeding, pulsatile tinnitus and hearing loss. Surgical resections of the mass are the mainstay of treatment.
A 24 year old man presented with left ear bleeding for 6 months in duration which was associated with otalgia, tinnitus and hearing loss. Otoscopy showed a vascular and angry looking mass filling up the entire left external auditory canal which bled on contact. No neurological or cranial nerve deficits were elicited. A high resolution computed tomography (HRCT) and a magnetic resonance imaging (MRI) showed an enhancing mass occupying the left jugular vein, left middle ear cavity, left mastoid air cells and left external auditory canal with infiltration into the left internal jugular vein and erosion of the surrounding bone. Digital substraction angiography showed a left glomus tumor which mass was supplied by the left ascending pharyngeal artery. The patient underwent embolization a day prior to the glomus tumor excision under general anesthesia. Intraoperatively the mass was noted to arise from the medial wall of the left middle ear, occupying the middle ear cavity and extending to the Eustachian tube and the hypotympanum. Part of the mastoid cavity was filled with soft tissue but the mastoid air cells were well aerated otherwise. The jugular bulb was not involved. Facial nerve was intact. Post operatively was uneventful. Histopathological examination of the mass showed features consistent with glomus tympanicum. On follow up 9 months later, patient was well and no evidence of tumor was found (Figures 1,2).
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