GLOMUS TYMPANICUM: Picture of a left tympanic membrane with a pulsating red mass occupying the inferior portion of the middle ear space. The rest of the tympanic membrane is normal.
GLOMUS TYMPANICUM: Magnification of the above picture
GLOMUS TYMPANICUM: This patient presented with a history of severe bleeding from the placement of a PE tube in her right ear. On examination, the posterior half of the tympanic membrane was red and pulsating.
GLOMUS TYMPANICUM: Surgical picture of the above patient. A tympanomeatal flap has been elevated and reflected anteriorly to expose the glomus tympanicum that filled the posterior half of the middle ear space.
Glomus tympanicum tumors are chemodectomas that arise from the glomus bodies that run with the tympanic branch of the glossopharyngeal nerve. They are are the most common primary neoplasms of the middle ear.
Glomus tumors of the head and neck paraganglia are part of the extra-adrenal neuroendocrine system. At birth, small patches of paraganglionic cells can be widely dispersed throughout the body, mostly in association with autonomic nervous tissue. In the head and neck, such areas include the chemoreceptive areas (glomus tissue) of the carotid bifurcations, the aortic arch, and the temporal bone. Mafee et al noted that paraganglionic cells are also found, although less frequently, in areas of the orbit (in association with the ciliary ganglion), pterygopalatine fossa (in association with the pterygopalatine ganglion), buccal mucosa, nasopharynx, larynx, and dermis. However, progressive involution, which lasts until puberty, normally obliterates the paraganglionic cells of these and other extra-adrenal locations.
Axial CT scan showing the glomus tumor growing from the medial wall of the middle ear.
Coronal CT scan showing the glomus tympanicum tumor growing from the medial wall of the middle ear.
Surgical picture of glomus tympanicum in the eft middle ear. The tympanomeatal flap has been raised and reflected anteriorly.