PARAGANGLIOMA JUGULARE Report a Case

Authors

Dr. med. Jorge Said Martinez (Mexico D.F., Mexico)
Dr.med. Alfonso Izita (Mexico D.F., Mexico)

Proceedings

XXXIX Congress of the NES - Bad Kissingen - Germany

Topics

Neurootology
Equilibrium
Diseases
Neurootology
Neurology
Diseases
Neurootology
Equilibrium
Neurootology
Neurology
Neurootology
Uncategorized

Keywords

Dizziness, paraganglioma, Tinnitus, Vertigo.

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Abstract

ABSTRACT
Glomus tympanicum and Glomus jugulare: Both commonly present as a middle ear mass resulting in tinnitus (in 80%) and hearing loss (in 60%). About 85% of paragangliomas develop in the abdomen; only 12% develop in the chest and 3% in the head and neck region (the latter are the most likely to be symptomatic). While most are single, rare multiple cases occur (usually in a hereditary syndrome). Paragangliomas are described by their site of origin and are often given special names:-Originate from chromaffin cells in paraganglia or chromaffin-negative glomus cells derived from the embryonic neural crest, of the sympathetic nervous system (a branch of the autonomic nervous sytem). These cells normally act as special chemoreceptors located along blood vessels.The cranial nerves of the jugular foramen may be compressed, resulting swallowing difficulty, or ipsilateral weakness of the upper trapezius and sternocleiodomastoid muscles (from compression of the spinal accessory nerve). These patients present with a reddish bulge behind an intact ear drum. This condition is also known as the “Red drum”.1 On application of pressure to the external ear canal with the help of a pneumatic ear speculum the mass could be seen to blanch. This sign is known as “Brown’s sign”. The diagnosis must be early, an GLOMUS JUGULARE is key to preventing its serious consequences. Unfortunately, early detection of the tumor is sometimes difficult, because the symptoms may be subtle and may not appear in the beginning stages of growth.2 Also,hearing loss, dizziness, and tinnitus inner ear problems. Therefore, once the symptoms appear, a thorough ear examination and hearing test are essential the study the vestibular function through of vestibuloespinal, retinalocular, vestibuloocular systems in the Cranio-Corpo-Graphy (CCG), the Test of Balance(TOB) and the Computarized Electronystagmography (CNG) in order to determine and orientate a better vestibular diagnosis.Computerized Tomography(CT) and Magnetic Resonance Imaging (MRI) are helpful in determining the location and size of a tumor and also in planning its removal.