The Hearing Loss That Pulsates

Abstract

Glomus jugulare tumor arises within the jugular foramen with close proximity to lower cranial nerves and major vessels. The aim of treatment is complete resection of tumor with preservation of cranial nerves. However, surgery carries high morbidities and challenging especially in large tumors. A 47-year-old woman experienced hearing loss followed by pulsatile tinnitus for 2 years. Upon a thorough examination and investigations, she was later diagnosed with glomus jugulare. Tumour was excised through transmastoid approach and residual tumour was left at surgery to prevent potential morbidities. She received adjuvant stereotactic postoperative radiotherapy. Due to insidious onset, high index of suspicion for glomus tumor is needed to initiate early treatment and reduce morbidity. Thus, tinnitus should not be underestimated. Combination of partial resection with postoperative radiotherapy is the most suited and effective treatment in large tumors with preservation of the function of cranial nerves. Routine postoperative MRI is beneficial to monitor residual and recurrence.