Head and Neck Imaging

Glomus tympanicum tumour

glomus tumour in the middle ear, originating from the glomus formation on the cochlear promontory. When the tumour also involves the jugular foramen, it is called a jugulotympanic tumour (see glomus jugulare tumour). The symptoms are pulsatile tinnitus, conductive hearing loss and, when the lesion extends towards the jugular foramen, possibly also cranial nerve involvement. Otoscopically, a vascular mass is seen behind the ear drum, but differentiation between a glomus tympanicum and jugulotympanicum is often not possible; also, vascular anomalies (see internal carotid artery partial absence) may mimic the clinical appearance of a glomus tumour.

CT shows a focal mass on the cochlear promontory (Fig.1). The mass may grow into the middle ear and block the aditus ad antrum, causing retro-obstructive inflammation in the mastoid cells; this may obscure the lesion on CT images. MRI shows the presence of an enhancing mass within the middle ear.

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Fig.1

Coronal CT image of left temporal bone. Small middle ear soft tissue mass (arrow) on the cochlear promontory.
Glomus tympanicum tumour, Fig.1