Type IV Glomus Tympanicum Presenting with External Auditory Canal Obstruction: A Case Report

Background:Glomus tympanicum is a benign, highly vascular paraganglioma arising from the paraganglia of the middle ear and represents the most common primary neoplasm of the middle ear. It typically presents with pulsatile tinnitus and conductive hearing loss and is more frequently observed in women in the fifth to sixth decades of life. Despite its benign histology, the tumor may show locally destructive behavior and can extend to adjacent temporal bone structures.Case:A 57-year-old female patient with a history of hypertension and hypothyroidism presented with progressive hearing loss and dizziness in the right ear for six months. Otoscopic examination revealed a pulsatile polypoid lesion completely obliterating the right external auditory canal. Audiological evaluation demonstrated severe hearing loss in the affected ear. Radiological evaluation with temporal bone computed tomography and magnetic resonance imaging revealed a mass completely occupying the middle ear cavity with extension into the mastoid air cells and the external auditory canal. The patient underwent surgical excision of the tumor via a postauricular approach with mastoidectomy. Histopathological examination confirmed the diagnosis of a benign vascular neuroendocrine tumor consistent with glomus tympanicum. Postoperatively, House–Brackmann grade IV facial nerve paralysis was observed, and corticosteroid therapy was initiated.Conclusion:Glomus tympanicum should be considered in the differential diagnosis of patients presenting with pulsatile tinnitus and conductive hearing loss. Careful otoscopic examination and radiological imaging are essential for accurate diagnosis and treatment planning. Surgical excision remains the primary treatment option, particularly in cases with extensive tumor involvement.