Tumors of the middle ear and mastoid are rare. The first symptom of a glomus tumor of the ear is pulsatile tinnitus followed by conductive hearing loss. A small percentage of paragangliomas produce hormones which, in rare cases, cause intermittent hypertension. A pulsatile red mass in the middle ear is the hallmark of glomus tumors. Tuning fork testing and an assessment of the cranial nerves may reveal abnormalities.
Audiometry usually demonstrates conductive hearing loss.
Tumors that infiltrate the labyrinth or VIIIth nerve cause neurosensory hearing loss. The evaluation of patients with a vascular middle ear mass begins with contrast-enhanced CT of the skull base and temporal bone. Occasionally, the vascular mass may be a abnormally located jugular bulb and is of no consequence. Treatment depends on the tumor's site of origin, size, the patient's age and general medical condition. In younger patients, complete surgical removal is the standard of care.