Relatively large tumors of the middle ear can be approached by using the Argon laser without opening the ear from behind. In using the Argon laser, the bones of hearing can be preserved. Larger tumors may surround the bones of hearing. In these cases, the tumor can be vaporized away from the bones of hearing without separating them in many cases. When a glomus tumor extends into the mastoid, it becomes necessary to make an incision behind the ear and open the mastoid bone.
Every attempt is made to preserve the wall that separates the middle ear from the mastoid.
This approach is called an intact canal wall or facial recess approach. The mastoid is completely cleared of disease, judiciously using the laser. The facial nerve is monitored to prevent injury. The entire tumor can be removed in this manner. Somtimes, the tumor may be attached to the jugular vein as it enters the mastoid bone.