Glomus jugulare tumor

  • Definition
    • A glomus jugulare tumor is a tumor of the part of the temporal bone in the skull that involves the middle and inner ear structures. This tumor can affect the ear, upper neck, base of the skull, and the surrounding blood vessels and nerves.

  • Alternative Names
    • Paraganglioma - glomus jugulare

  • Causes
    • A glomus jugulare tumor grows in the temporal bone of the skull, in an area called the jugular foramen. The jugular foramen is also where the jugular vein and several important nerves exit the skull.

      This area contains nerve fibers, called glomus bodies. Normally, these nerves respond to changes in body temperature or blood pressure.

      These tumors most often occur later in life, around age 60 or 70, but they can appear at any age. The cause of a glomus jugulare tumor is unknown. In most cases, there are no known risk factors. Glomus tumors have been associated with changes (mutations) in a gene responsible for the enzyme succinate dehydrogenase (SDHD).

  • Symptoms
    • Symptoms may include:

      • Difficulty swallowing (dysphagia)
      • Dizziness
      • Hearing problems or loss
      • Hearing pulsations in the ear
      • Hoarseness
      • Pain
      • Weakness or loss of movement in the face (facial nerve palsy)
  • Exams and Tests
  • Treatment
    • Glomus jugulare tumors are rarely cancerous and do not tend to spread to other parts of the body. However, treatment may be needed to relieve symptoms. The main treatment is surgery. Surgery is complex and is most often done by a neurosurgeon, head and neck surgeon, and ear surgeon (neurotologist).

      In some cases, a procedure called embolization is performed before surgery to prevent the tumor from bleeding too much during surgery.

      After surgery, radiation therapy may be used to treat any part of the tumor that could not be removed completely.

      Some glomus tumors can be treated with stereotactic radiosurgery.

  • Outlook (Prognosis)
    • People who have surgery or radiation tend to do well. More than 90% of those with glomus jugulare tumors are cured.

  • Possible Complications
    • The most common complications are due to nerve damage, which may be caused by the tumor itself or damage during surgery. Nerve damage can lead to:

      • Change in voice
      • Difficulty swallowing
      • Hearing loss
      • Paralysis of the face
  • When to Contact a Medical Professional
    • Call your health care provider if you:

      • Are having difficulty with hearing or swallowing
      • Develop pulsations in your ear
      • Notice a lump in your neck
      • Notice any problems with the muscles in your face
  • References
    • Marsh M, Jenkins HA. Temporal bone neoplasms and lateral cranial base surgery. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 176.

      Rucker JC, Thurtell MJ. Cranial neuropathies. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 104.