Glomus tumors of the temporal bone - Report of four cases

Glomus tumor is a benign neoplasm most commonly encountered in the temporal bone, occurring at a rate of 0.6% of all head and neck tumors. The most common presenting symptom of the glomus tumors is pulsatile tinnitus. The glomus tumor usually manifests as reddish mass behind intact ear drum. A useful tool for diagnosis and preoperative evaluation of the tumor is high resolution CT scan of temporal bone, and surgical excision of the glomus tumor is the treatment of choice. Since October, 1994 to March, 1997, we collected four such cases of glomus tumor and reported herein. Surgical excision of the tumors were performed with different approach according to clinical classification of the tumors on the basis of findings of the CT scan after pre-operative embolization. Only one of these four patients was observed to have unexplainable post-embolization vocal palsy and all of them showed no recurrence of tumor during a follow-up for a period of 6 months to 3 years. Although the third case is lack of typical 'pulsatile tinnitus', the fact that hearing preservation can be achieved on early diagnosis emphasizes importance of high index of suspicion about the existence of this tumor by careful inspection of ear drum. Glomus tumors of the temporal bone usually have good prognosis if early diagnosis and treatment can be made.