Glomus Tympanicum Tumors: Contemporary Concepts in Conservation Surgery

At the meeting of the Western Section of the Triological Society in Laguna Niguel, Calif, conservation surgery of glomus tympanicum tumors was discussed by D. Brad Welling, MD, and collaborators, Nashville, Tenn. The motivation for this report was twofold: continuing referrals of misdiagnosed patients to the authors, and recent reports in the literature supporting radiation therapy for cure. In 1945, Rosenwasser first described surgical treatment for the lesion he called "glomus tympanicum." This lesion arises in the middle ear and causes tinnitus, hearing loss, and a visible mass behind the tympanic membrane. Diagnosis is confirmed by a third-generation computed tomographic scanner using 1.5-mm cuts in both the axial and coronal planes. Angiography is useful to identify feeding vessels. At its present state of development, magnetic resonance imaging will help identify extension into the brain cavity as well as multiple tumors (2 of 60 cases). Gadolinium-enhanced magnetic resonance imaging may prove