Earliest symptom of glomus tumor is ?
Correct Answer: Pulsatile tinnitus
Description: Ans. is 'a' i.e., Pulsatile tinnitus Clinical features of glomus tumor The earliest symptoms of glomus tumour is pulsatile tinnitus (earliest) and hearing loss. Hearing loss is conductive and slowly progressive. These are followed by blood stained otorrhoea and earache. Before the tympanic membrane (eardrum) is perforated a red swelling is seen to arise from the floor of middle ear, i.e. "Rising sun" appearance. This results in a red reflex through the intact tympanic membrane. Sometimes, eardrum may be bluish and bulging. Pulsation sign (Brown sign) is positive, i.e. when ear canal pressure is raised with Siegle's speculum, tumor pulsates vigorously and then blanches; reverse happens with release of pressure. Aquino sign is positive, i.e. blanching of mass with manual compression of ipsilateral carotid aery. When the tumour perforates the eardrum a polypus will be seen in the meatus and this will bleed profusely if touched. Cranial nerve palsies is a late feature appearing several years after aural symptoms. IX' to XIIth cranial nerves may be paralysed. This can cause dysphagia and hoarseness, and weakness of trapezius and sternocleidomastoid muscles, unilateral paralysis of soft palate, pharynx and vocal cord. Ausculation with stethoscope over the mastoid may reveal audible systolic bruit. Some glomus tumours secrete catecholamines and produce symptoms like tachycardia, arrhythmias, sweating, flushing and headache etc. Facial palsy may be caused by glomus tympanicum type of glomus tumor. Audiometry shows conductive deafness, However if inner ear is invaded, mixed conductive and sensorineural hearing loss is seen.
Category:
ENT
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