Introduction: Jugulotympanic glomus tumors are the second most common temporal bone tumors. These tumors arise from the glomus cells in the jugular bulb area and may extend both intra and extra-cranially. (1)

Methods: Retrospective study of 18 cases of Jugulo-tympanic glomus tumor operated from 2008 to 2015.

Results: The mean age of the presentation was 37 years. The male to female sex ratio was 0.3 (5/13).The conductive hearing loss was found in 50% of cases, mixed type in 16.7 % cases and sensineural hearing loss found in 27.8 % cases and no hearing loss was found in 5.6 % cases. Tinnitus was present in 61 % of patients. Preoperative facial paresis was found on 61% cases. Half (50 %) of the patients presented with clinical evidence of lower cranial nerve paresis. Around 73 % of tumors were more than 3 cm size (mean size 4.7 cm). Importantly, one patient had undergone stereotactic radiosurgery one year back but the symptoms deteriorated. Preoperative angiogram was done in all cases and amongst these 14 patients (77.7%) underwent preoperative embolization procedure. Pre-sigmoid trans-petrous approach was done in 14 cases. Combined two stage surgery was done in four cases. Post-operative new / worsened facial paresis was observed in 72.2 % cases in immediate post-operative period. Hearing was preserved in 88.8% of patients with existing preoperative normal/conductive hearing loss. At follow up of six months 84.6 % of patients with post-operative facial paresis improved up to H& B grade 4. Only one patient had postoperative CSF leak that required a lumbo-peritoneal shunt. There was no mortality in our series.

Conclusions: Glomus tumors are common temporal bone tumors. Most patients in India present late with large tumors. Lateral skull base micro-surgery offers optimum therapy with minimum morbidity. Radio surgery may not be effective in all cases.

Patient Care: A complete surgical excision of benign glomus neoplasm gives a complete cure at an affordable cost with minimal complications. Expensive stereotactic radiosurgery (SRS) for these tumors can be avoided in many patients. Long term effects of SRS is unpredictable at present.

Learning Objectives: At the end of the presentation, we will learn about the temporal bone glomus tumors, its classifications and management aspects. We will also learn the nuances of the surgical technique by trans-temporal approach, its outcome as compared to stereotactic radiosurgery.

References: 1)Jackson CG. Glomus tympanicum and glomus jugulare tumors. Otolaryngol Clin North Am 2001; 34(5):941-70.