There are many ways I could go with a title. But this time it does not consist of a bug looking back at you, moving around in your ear canal, making it sound like there is a bass drum in your ear! As I continue with certain conditions we may encounter during the course of our practices, this week I highlight the “glomus tumor.”
I have seen two glomus tumors in my +20 years. In one case, I was part of the team that discovered it. Some sites say that glomus tumors are rather common; most sites say they are rare (see text links in this post) . Glomus tumors can form in three places– around the carotid (which actually grows around the jugular veins and carotid artery), the vagus nerve (tenth cranial nerve) and tympanic membrane. The tumors are benign, slow-growing and highly vascularized, which gives them a pulsating look.
When you visualize a glmus tumor around the tympanic membrane using otoscopy, it appears very red. The tumors can be behind the eardrum, making the eardrum appear pulsatile and producing pulsatile tinnitus in the subject. Pulsing tinnitus matches the blood flow from the patient.
Normally treatment for glomus tumors begins with observation, since they are slow growing. Imaging studies use either a CT and/ or MRI. Radiation therapy may follow next and finally, a surgery may be required to remove the tumor.
If the tumor grows large enough it can start pressing on the middle ear bones and affect the hearing more severely. It may grow into the mastoid area or around the facial nerve and can even attach itself to the jugular vein and carotid artery. Radiation treatment’s goal is mainly to slow the growth while surgery attempts to remove the tumor completely. There are risks with either treatment, but the growth of the tumor is what the surgeon is most interested in–treatment’s goals are to minimize damage to the inner ear, avoid the possibility of facial paralysis and prevent further invasive tumor growth.
There are small support groups starting up: the one on Facebook has just 18 “likes” as of today, but seems informative for those who find themselves with this condition.