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Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Glomus Tympanicum Tumors

Glomus tympanicum tumors (also known as paragangliomas of the middle ear) are highly vascular, benign (non-cancerous) tumors that arise from paraganglia in the middle ear. Conductive hearing loss is common due to the tumor occupying space within the middle ear and preventing transmission of sound through the eardrum and ossicular (hearing bone) chain. Additionally, pulsatile tinnitus, which is the sensation of hearing one’s pulse, occurs frequently due to the vascular nature of these tumors. Very large glomus tympanicum tumors may cause vertigo (feeling that the world around you is spinning when you are not moving), facial paralysis and sensorineural hearing loss. Rarely, hormones may be manufactured by the tumor, which cause rapid heartbeat, headaches, flushing, excessive sweating and diarrhea. Smaller glomus tympanicum tumors may not produce any symptoms but can be found incidentally as reddish mass lesions under the eardrum.

Glomus tympanicum tumors are first valuated in the office by a thorough (binocular) microscope examination of the ear. Due to the highly vascular nature of the tumor, a reddish mass is typically observed behind the eardrum. Imaging studies such as temporal bone fine-cut CT scans, MRI scans with IAC protocol, and CT or MR angiography are indicated. Treatment recommendations are based on the individual properties of each tumor. Because these tumors are slow growing, observation using serial imaging is an option if the tumor is small and not causing troublesome symptoms. Surgical removal ranges from relatively simple transcanal approaches to much more complex mastoid and petrous operations depending on the size, location of the tumor and extent of other structures involved. In many cases, hearing and facial nerve function can be preserved with surgery; however, this is not always the case. Radiation therapy can also be considered either alone or in combination with surgery since this treatment may halt the growth of the tumor by cutting off its blood supply; however, radiation alone does not remove the tumor and lifelong surveillance imaging is required.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care for his patients.
  • Glomus tumors require the special expertise of a Neurotologist/Lateral Cranial Base Surgeon. Having completed fellowship in Cranial Base Surgery with Dr. Bradley Welling (now ENT chair at Harvard), Dr. Jacob is uniquely qualified to surgically navigate the complex anatomy of the lateral skull base/temporal bone. Interfacing with the Neurosurgeons for removal of extensive glomus tumors invading the intracranial space, Dr. Jacob’s skills have brought a new scope and breadth to the surgical services offered at the Center for Neurosciences.