True about Glomus jugalre are all EXCEPT:
Correct Answer: Invades epitympanum
Description: ANSWER: (D) Invades epitympanumREF: Dhingra 4th ed p. 107Glomus TumourIt is the most common benign neoplasm of middle ear and is so-named because of its origin from the glomus bodies. The latter resemble carotid body in structure and are found in the dome of jugular bulb or on the promontory along the course of tympanic branch of IXth cranial nerve (Jacobson's nerve).The tumor is often seen in the middle age (40-50 years). Females are affected five times more.Types:Glomus jugulare: They arise from the dome of Jugular bulb, invade the hypotympanum and jugular foramen, causing neurological signs of IXth to Xllth cranial nerve involvement.Glomus tympanicum: They arise from the promontory of the middle ear and cause aural symptoms, some times with facial paralysis.Clinical Features1. When tumor is intra tympanic:Earliest symptoms are deafness and tinnitus. Deafness is conductive and slowly progressive. Tinnitus is pulsatile and of swishing character, synchronous with pulse, and can be temporarily stopped by carotid pressureOtoscopy shows a red reflex through intact tympanic membrane.' Rising sun' appearance is seen when tumor arises from the floor of middle ear."Pulsation sign" (Brown s sign) is positive, i.e. when ear canal pressure is raised with Siegle's speculumWhen tumor presents as a polyp:In addition to deafness and tinnitus, there is history of profuse bleeding from the earDizziness or vertigo and facial paralysis may appear,Cranial nerve palsies:This is a late feature appearing several years after aural symptoms.IXth to XIIth cranial nerves may be paralyzed.
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