Endoscopic surgery of glomus tympanicum

Endoscopic surgery of glomus tympanicum
Sohrab Rabiei MD, Associated professor
Kermanshah university of Medical Sciences

Glomus tympanicum (GT) is the most common benign tumor of the middle ear. Patients present with conductive hearing loss, pulsatile tinnitus and a red mass behind tympanic membrane. Complete surgical resection has been the preferred treatment for GT. It is important to preserve the function of middle ear.

Surgical excision, whether via a transcanal or postauricular approach, remains the mainstay of treatment and must be done through transcanal , postauricular incision and mastoidectomy, extended posterior tympanotomy, hypotympanotomy and totally by endoscopic assisted excision. Tumor dissection should always be performed in a meticulous fashion. Cotton soaked with a hemostatic agent, bipolar electrocautery, and laser dissection can be useful tools for managing bleeding.

The exposure and visualization of the entire middle ear space are sometimes difficult using only microscopic vision therefore the benefits of using transcanal endoscopic ear surgery (TEES) includes: enhances visualization, ensure complete tumor removal, reducing unnecessary dissection, reducing associated morbidity, views of hidden areas (sinus tympani, facial recess, anterior epitympanic spaces, attic, hypotympanum and protympanum) and examine behind corners without radically changing middle ear anatomy.

In this presentation we describe a stapedectomy-type transcanal approach and explain our method for resection of GT with minimal invasive and minor bleeding without using any bipolar electrocautery and laser for coagulation.