Endoscopic Management of Glomus Tympanicum Tumor: Report of Three Cases and Review of the Literature

Abstract

Glomus tympanicum are benign tumors of vascular origin, arising from the neural crest cells and located on promontory. The treatment of choice is surgical excision of the lesion. Traditionally, it is performed under microscopic observation. With the introduction of endoscopes in the field of ear surgeries, an endoscopic approach has also evolved. Herein, we present case reports of three patients diagnosed with glomus tympanicum tumors who were operated on using an endoscopic approach. A review of the literature is also performed. The mass was completely excised in all patients, and there were no signs of recurrence at the follow-up at least a year later. Endoscopic ear surgery is a safe and effective method of managing glomus tympanicum tumors. Its main limitation is the tumor size; however, in most cases, tumors of stages I to II as per the Glasscock-Jackson classification and types A1 to B1 according to the modified Fisch-Mattox classification can be completely removed endoscopically. Careful preoperative selection of patients warrants the best outcomes.

Endoscopic Versus Microscopic Transcanal Resection of Glomus Tympanicum: A Retrospective Comparative Study

“…Previously, 12 case series and case reports including a total of 90 patients have detailed endoscopic GT resection outcomes (Supplementary Table 1, http://links.lww.com/ MAO/B847) (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Across these studies, 86 cases were completed entirely with an endoscopic approach, and four cases converted to a mixed endoscopic-microscopic approach due to anatomic challenges (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Complete tumor resection was achieved in 87 patients, with the remaining three patients demonstrating anatomic challenges due to the proximity of tumor to the internal carotid artery (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

“…Across these studies, 86 cases were completed entirely with an endoscopic approach, and four cases converted to a mixed endoscopic-microscopic approach due to anatomic challenges (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Complete tumor resection was achieved in 87 patients, with the remaining three patients demonstrating anatomic challenges due to the proximity of tumor to the internal carotid artery (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Among all patients who had gross total resection, none showed tumor recurrence during follow-up and all patients experienced resolution of pulsatile tinnitus (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

“…Complete tumor resection was achieved in 87 patients, with the remaining three patients demonstrating anatomic challenges due to the proximity of tumor to the internal carotid artery (3–14). Among all patients who had gross total resection, none showed tumor recurrence during follow-up and all patients experienced resolution of pulsatile tinnitus (3–14). These studies suggest that endoscopic GT resection is a safe and effective treatment approach.…”

“…The present study aims to compare the outcomes of microscopic and endoscopic transcanal GT resection. Previously, 12 case series and case reports including a total of 90 patients have detailed endoscopic GT resection outcomes (Supplementary Table 1, http://links.lww.com/ MAO/B847) (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Across these studies, 86 cases were completed entirely with an endoscopic approach, and four cases converted to a mixed endoscopic-microscopic approach due to anatomic challenges (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

“…Previous studies have documented the feasibility of endoscopic approaches to GT resection (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). However, no studies to date include a comparison to the traditional microscopic approach for tumor removal.…”