DR.SUDEEP K.C. TUMOURS OF MIDDLE EAR AND MASTOID. CLASSIFICATION. 1)Primary Tumours: Benign Glomus tumour Malignant Carcinoma ,sarcoma 2)Secondary Tumours: a) From adjacent areas like nasopharynx , external meatus and parotid.
Benign Glomus tumour
Malignant Carcinoma ,sarcoma
a) From adjacent areas like nasopharynx , external meatus and parotid.
b)Metastatic eg. From ca of bronchus, breast, thyroid, prostrate, GIT.
Two types of glomustumours:
1)Glomusjugulare: They arise from dome of jugular bulb, invade hypotympanum and jugular foramen , causing neurological sign of IX th to XII th cranial nerve involvement . They may compress or invade lumen of jugular vein.
2)GlomusTympanicum: They arise from promontory of middle ear and cause aural symptoms sometimes with facial paralysis.
Earliest symptoms are deafness and tinnitus.Deafness is conductive type and tinnitus is pulsatile.
Otoscopy show red reflex through intact TM. “Rising sun”appearance is seen.
“Pulsation sign”(Brown’s sign) is positive.
B) When tumour present as polyp: profuse bleeding from ear either spontaneously or after cleaning.
Dizziness or vertigo and facial paralysis may appear . Earache less common otorrhoea due to secondary infection.Examionation reveals red vascular polyp.
1)CT scan head
3)Four vessel angiography
Age- 40 to 60, females>males,chronic irritation may be the cause.
Tumour may arise primarily from middle ear or be an extension of ca of deep meatus . Squamous cell variety is most common .
Thank you cranial nerves may be involved.dysphagia , hoarsness with unilateral paralysis of soft palate, pharynx and vocal cord.